Pregnancy Associated Acute Kidney Failure: Early clinical insights

  • Jais Kumar Akbar Niazi Teaching Hospital, Islamabad
  • Mohammad Ali
  • Asim Hassan
Keywords: pregnancy related acute kidney failure, renal failure



The goal is to characterise the clinical spectrum of acute renal illness associated with pregnancy and its effects on maternal and foetal morbidity and mortality.
Methodology: This Case-series was conducted at Department of Nephrology, Akbar Niazi Teaching Hospital, Islamabad from February 2022–February 2024. Pregnancy-related acute renal failure has been defined as abrupt onset oligoanuria or a blood creatinine level more than 1.5 milligrammes% on two consecutive occasions. Patients who had preexisting CKD had been excluded from the research.

Results: 350 people suffering from acute renal failure received medical care in a single year. A total of 55 women met the PR-ARF criterion. The incidence of PR-ARF reported 50/350 (14.2%). The clinical spectrum includes 20/51 (39.2%) instances of PIH, PET, and eclampsia, with or without sepsis/DIC. 7/55 (12.5%) developed acute tubular necrosis, whereas 9/55 (16.3%) developed puerperal sepsis. 12/55 (21.8%) patients experienced sepsis in addition to ATN, and three of them had a septic abortion. RPGN 1/55 (1.8%), and early cortical necrosis 1/55 (1.8%). Pregnancy-related ARF was most common in the third trimester/postpartum period, accounting for 45/55 (81.8%). It was followed by vaginal birth in 31/55 (56.36%) patients, 15/55 (27.2%) after a caesarean delivery, and 3/55 (5.4%) following septic abortion with Dai management. Dai (the conventional delivery attendant) handling was seen in 17/55 (30.9%).Antenatal care was unavailable to 38/55 (69.0%). Maternal outcomes revealed that 16/55 (29.0%) individuals died, 25/55 (45.5%) recovered completely, 2/55 (3.6%) recovered partially, and 4/55 (7.2%) had permanent renal failure. The outcome was uncertain in 3/55 (5.4%).

Conclusion: The most prevalent cause of pregnancy-related acute kidney damage is PIH, which is often accompanied with additional risk factors such as abruption, IUD, DIC, and RPOC. In PR-ARF, sepsis is the primary contributing factor. The majority of patients did not get prenatal care or Dai management. Pregnancy-related acute renal failure presents a significant maternal death and morbidity rate.

Keywords: Pregnancy related acute kidney failure, renal failure.

Original Articles