Acute Kidney Injury in Pregnancy at Jinnah Postgraduate Medical Centre Karachi

Aim: To determine the etiology and outcome of acute kidney injury in pregnant women. Study Design: Descriptive, case series study. Place and Duration of Study: Department of Nephrology, Jinnah Postgraduate Medical Centre, Karachi from 2nd August 2018 to 1st February 2019 Methodology: One hundred and thirty pregnant women with acute kidney injury of age 18-40 years were included. Patients with CKD, hypertension, diabetes mellitus, renal stones and small sized echogenic kidneys were excluded. After taking written consent from each patient, all patients were assessed for etiological factors (antepartum hemorrhage, postpartum hemorrhage, puerperal sepsis, disseminated intravascular coagulation and HELLP syndrome). All patients were given treatment as per the departmental protocol and patient prerequisite. All patients remained in ward till final outcome (complete recovery/progression to chronic kidney disease/maternal mortality) was evaluated. Results: The etiology of ARF in pregnant females was found to be antepartum haemorrhage in 24 (18.46%), postpartum haemorrhage in 41 (31.54%), puerperal sepsis in 35 (26.92%), DIC in 13 (10.0%) and HELLP syndrome in 17 (13.08%) patients. Regarding outcome in these patients, maternal mortality was seen in 07 (5.38%) patients, 89 (68.46%) had complete recovery of renal function and 34 (26.15%) progressed to chronic kidney disease. Conclusion: The postpartum hemorrhage is the most widely recognized reason of acute kidney injury in pregnancy followed by puerperal sepsis.