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Pregnancy-related acute kidney injury prevalent in women with pre-eclampsia

15 Oct 2019

Women with pre-eclampsia commonly have acute kidney injury (AKI), which is associated with higher rates of maternal and perinatal mortality, a study reports.

The study followed a total of 1,547 women admitted with pre-eclampsia who presented with maximum creatinine concentration of ≥90 μmol/L during admission in South Africa. Of these, 237 patients (15.3 percent) met the AKI criteria: 107 (6.9 percent) had stage 1 disease, 67 (4.3 percent) had stage 2 disease and 63 (4.1 percent) had stage 3 disease.

Women with vs without AKI were at greater risk of maternal death (relative risk, 4.3, 95 percent CI, 1.6–11.4) and stillbirth (relative risk, 2.2, 1.8–2.8). Additionally, perinatal mortality was high in women with AKI (89 of 240; 37.1 percent).

Hypertension in a previous pregnancy emerged as the strongest predictor of AKI stage 2 or 3 (odds ratio, 2.24, 1.21–4.17). Renal recovery rate decreased with increasing AKI stage. By discharge, renal function did not return to baseline in about a third of the surviving women (76 of 230; 33.0 percent), approximately half of whom (39 of 76; 51.3 percent) did not have further creatinine testing postdischarge.

Researchers highlighted a need for additional investigation to determine the short- and long-term outcomes of pregnancy-related AKI and whether this varies according to underlying pathogenesis. They encouraged clinicians to follow-up women with AKI whose renal function did not return to baseline at discharge.

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Most Read Articles
01 Nov 2019
Women with hypertensive disorders of pregnancy, especially pre-eclampsia, are at heightened risk of developing cardiovascular disorder and chronic hypertension, with the risk becoming apparent soon after pregnancy, a study has found.
Roshini Claire Anthony, 29 May 2019

Gestational diabetes and abnormal glucose levels in pregnancy, as determined with an oral glucose challenge test (OGCT) at 24–28 weeks gestation, could signal a future risk of cardiovascular disease (CVD)*, according to a recent study.

07 Jul 2019
Plasma creatinine kinase activity, measure during early pregnancy, influences blood pressure during pregnancy and contributes to severe gestational hypertension diagnosed before 34 weeks of gestation, according to a recent study. There is no association between creatinine kinase and other hypertensive disorders during pregnancy.
Pank Jit Sin, 16 Oct 2019
While a diagnosis of cancer is often met with concern and devastation, the same is barely true for heart failure. However, the mortality rate for those suffering from heart failure is worse than some common cancers, such as prostate and breast cancers.