Abstract
Pregnancy related acute kidney injury (PrAKI) is associated with significant maternal and fetal morbidity and mortality. Although there has been a reduction in the incidence of PrAKI in the developed countries as a result of better antenatal and postnatal care, in developing countries PrAKI is still a major concern. The commonest risk factors associated with PrAKI in developing countries are sepsis, hemorrhage and preeclampsia/eclampsia. The aim of this study was to describe the socio-demographic, clinical patterns and outcomes of patients diagnosed with PrAKI in a Nigerian public tertiary hospital. This was a retrospective cross-sectional study of all cases of PrAKI managed at the institution from January 2017 to December 2017. Clinical records were obtained from the Obstetric unit. Socio-demographic data, information on health status, relevant history, examination findings, investigations, and outcome of treatment were collated using Microsoft excel and data analyzed with IBM SPSS version 22. AKI was regarded as an absolute value of serum creatinine more than 1mg/dl, irrespective of urine output. Forty-two cases of PrAKI were managed during the one-year period. Mean age was 32.2 ± 6.9 years, and majority (64%) were between 25-34years; 57% of the women were primiparous while 29% were multiparous. Only 2.4% of patients diagnosed with PrAKI had attained 30 level of education. A high proportion (52%) were unbooked pregnancies. The commonest risk factors for PrAKI were preeclampsia 35.7%, eclampsia 31.0%, sepsis 28.6%, and haemorrhage 14.3%; 24% of the women had previous medical history of hypertension, while 12% were HIV sero-positive. Mortality rate was 36%. Pregnancy related AKI is common among young pregnant women with below tertiary level of education. The leading risk factors are pre-ecclampsis/ecclampsia, sepsis and peri-partum haemorhhage. Mortality rate remains very high.
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