P0613POSTPARTUM ACUTE RENAL FAILURE AND VITAMIN D STATUS A MULTICENTER STUDY OF RISK FACTORS

Abstract

Abstract Background and Aims The postpartum AKI is a particular pathological and chronological entity, which remains a public health problem in Algeria. The main objective was to describe the epidemiological, clinical and evolutionary profile of postpartum AKI and secondarily to evaluate the impact of Vit D status on: The severity of AKI (using AKIN Classification 2012), the use of the RRT and the Delays and quality of recovery of renal function. Method This is an observational, descriptive, prospective and multicentric study performed in two University hospital centers situated in East of Algeria (Annaba and Setif). All patients admitted to ICU for postpartum complications over a 4 year (2014 to 2018) were included. Results Among the 538 pathological post partums identified in the two basins of life 179 (33.28%) presented AKI, the average age is 32.9 years and the average delivery time is 33.88 weeks. AKI was defined by the KDIGO AKIN classification, the proportion of severe AKI requiring RRT was 34 (18.9%) and the incidence of CKD was 6.7 % with dialysis dependence for 1.11%. Preeclamptic pathology is in the most commen cause of postpartum AKI (72.3%). However, it is not associated in univariate analysis with the occurrence and severity of AKI. Associated factors (p <0.05) in univariate and multivariate analysis are: the HELLP syndrome, especially when associated with postpartum hemorrhage (PPH) and acute fatty liver of Pregnancy. Maternal mortality is dramatically high 20% especially in severe stage of AKI. Absolute deficiency of vitamin D (25OH D) < 10ng/ml is correlated with the severity of the AKI. Conclusion The postpartum AKI is inexorably linked to pre-eclamptic pathology and its complications. The frequency of maternal and fetal deaths should prompt new strategies including early detection and closer surveillance, especially of women at risk. A particular attention should be given to vitamine D sttatut during Pregnancy