Management and outcome assessment of pregnancy-related acute kidney injury in Western India: a single centred, prospective, observational study

Background: Pregnancy-related acute kidney injury (PRAKI) remains a large public health problem, with decreasing incidences in developing countries like India. However, some single centred studies from United States and Canada revealed an increasing incidence of PRAKI. This increase could be due to higher rates of hypertensive disorders of pregnancy.Methods: To assess the management and outcome of PRAKI. In this prospective, observational study, total 1021 cases of acute renal failure were observed.Results: 96 (9.4%) were of obstetric origin and enrolled as per inclusion criteria. Regarding management of PRAKI, 78 out of 96 (81.25%) required haemodialysis. 67 (69.79%) among them were managed with intermittent haemodialysis (IHD) while 10 (10.41%) who had hypotension at presentation were dialysed with slow, low efficiency dialysis (SLED). Continuous renal replacement therapy (CRRT) was done in 1 (10.4%) patient. Maternal mortality in this PRAKI study was 19 of 96 patients (19.79%). Sepsis accounted for 52.63% of deaths. Foetal death was observed in 58 out of 96 patients (60.41%) comprising of intrauterine death in 55 (55.29%) and abortion in 3 (3.13%) patients. 38 of 96 (39.58%) patients gave birth to live born child out of which 27 were at full term and 11 were preterm.Conclusions: In order to avoid further increase in PRAKI in India, treating obstetrician should remain aware of management and outcome of PRAKI. The better awareness of diagnosis and management protocols will ultimately lead to further reduction in prevalence of PRAKI in our country.

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Levels of Protein C and Soluble Thrombomodulin in Critically Ill Patients with Acute Kidney Injury: A Multicenter Prospective Observational Study

PLoS ONE ◽

10.1371/journal.pone.0120770 ◽

2015 ◽

Vol 10 (3) ◽

pp. e0120770 ◽

Cited By ~ 9

Author(s):

Josée Bouchard ◽

Rakesh Malhotra ◽

Shamik Shah ◽

Yu-Ting Kao ◽

Florin Vaida ◽

...

Keyword(s):

Acute Kidney Injury ◽

Observational Study ◽

Critically Ill ◽

Critically Ill Patients ◽

Protein C ◽

Prospective Observational Study ◽

Kidney Injury ◽

Soluble Thrombomodulin ◽

Multicenter Prospective Observational Study

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Acute kidney injury after liver transplantation, perioperative risk factors, and outcome: prospective observational study of 1681 patients (OLTx Study)

Minerva Anestesiologica ◽

10.23736/s0375-9393.21.15860-2 ◽

2021 ◽

Author(s):

Silvia FIORELLI ◽

Giandomenico BIANCOFIORE ◽

Paolo FELTRACCO ◽

Bruna LAVEZZO ◽

Andrea DE GASPERI ◽

...

Keyword(s):

Risk Factors ◽

Liver Transplantation ◽

Acute Kidney Injury ◽

Observational Study ◽

Prospective Observational Study ◽

Kidney Injury ◽

Perioperative Risk ◽

Perioperative Risk Factors

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Incidence and Risk Factors of Acute Kidney Injury in Patients Hospitalized with Pneumonia: A Prospective Observational Study

Medical Journal of the Islamic Republic of Iran ◽

10.47176/mjiri.35.150 ◽

2021 ◽

Author(s):

Muzamil Latief ◽

Reyaz Ahmed Para ◽

Obeid Shafi ◽

Zhahid Hassan ◽

Summyia Farooq ◽

...

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Observational Study ◽

Prospective Observational Study ◽

Kidney Injury

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Evaluation of Aetiology and Outcome of Acute Kidney Injury in a Tertiary Care Hospital of India- A Prospective Observational Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2020/45161.13845 ◽

2020 ◽

Author(s):

VS Gaurav Narayan ◽

SG Ramya ◽

Sonal Rajesh Kumar ◽

SK Nellaiappa Ganesan

Keyword(s):

Acute Kidney Injury ◽

Intensive Care ◽

Observational Study ◽

Prospective Observational Study ◽

Tertiary Care ◽

Kidney Injury ◽

Rapid Decline ◽

Care Hospital ◽

Medical Intensive Care

Introduction: The Acute Kidney Injury (AKI) is a rapid decline in renal filtration function. The aetiological spectrum, prevalence of AKI and outcome is highly variable. This variation exists due to the difference in the criteria used, study population and demographic features. Huge differences are noted when AKI is compared in developing and developed countries. Hence, it is important to analyse the spectrum of AKI to facilitate earlier diagnosis and treatment which shall help in improving the outcome. Aim: To study the prevalence, aetiology and outcome of AKI in the medical intensive care. Materials and Methods: This was a prospective observational study conducted in a medical intensive care for 18 months where 1490 patients were screened and 403 patients were included as AKI by KDIGO criteria. History, examination, appropriate investigations and treatment details including dialysis were noted. The serum creatinine levels were obtained every day, to know the time of onset of AKI, at the time of death or discharge, and after one month for patients who turned up for follow-up. Patients were categorised based on outcome as survivors and nonsurvivors. Survivors were divided into as fully recovered and partially recovered and those who left the Intensive Care Unit (ICU) against medical advice were termed as lost to follow-up. Results: A total of 403 patients (27.04% of 1490) of medical intensive care admissions were found to have AKI. Sepsis was the most common cause of AKI. At the end of the month, 78.4% of AKI patients fully recovered, 1.2% partially recovered and the mortality was 14.9%. Mortality was higher in AKI associated with chronic medical conditions like cardiac failure, chronic liver disease and stroke. Conclusion: If treated early, AKI is mostly reversible. Regional differences in AKI should be studied extensively and local guidelines should be formulated by experts for prevention and early treatment, to improve the disease outcome.

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