Clinical Audit of Acute Kidney Injury in Critically Ill Obstetric Patients
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Abstract
Background: Pregnancy-related acute kidney injury (PRAKI) has a bimodal distribution. Study aimed to analyze epidemiological factors causing AKI in critically ill obstetric women and required early interventions. Materials and Methods: The study was conducted in an Obstetrics intensive care unit over a year. Total 447 obstetric patients admitted in critical care unit were recruited, 162 critically ill women who developed AKI were enrolled and followed for 3 months for renal outcome, AKI defined as per KDIGO guidelines. Data was collected through a structured questionnaire, medical records, and daily follow-ups until discharge. Analyses included ABG, complete blood count, serum urea, creatinine, PT/INR, and electrolytes. Critical illness was evaluated using the APACHE II score. Results: AKI incidence was 36.2%, hypertensive pregnancy disorders being the major cause (50.6%). Sepsis was most common mortality factor (27.16%), followed by hemorrhage (20.73%). 19.4% women died. Those patients who developed AKI, 70% recovered completely, 6.4% partially, 4.4% progressed to end stage renal disease. 71.6% cases of AKI were of antenatal. After 3 months of follow up, complete recovery significantly higher in Stage I AKI (96.4%) and Stage-II (81.3%) while rate of partial recovery and deaths were higher in Stage III AKI vs stage II (36.8%&15.8%). Higher APACHE II score (19.72±5.00) was associated with stage III AKI. Duration of ICU stay (4.56±4.82), duration of intubation (3.74±5.31) and requirement of vasopressor support significantly associated with adverse outcome. Conclusion: Higher stages of acute kidney injury (AKI) resulted in higher mortality, morbidity, APACHE II score, intervention and intubation requirements, and ICU stay.
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Copyright (c) 2025 Rekha Sachan, Munna Lal Patel, Himani Chaudhary, Radhey Shyam
This work is licensed under a Creative Commons Attribution 4.0 International License.
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Rekha Sachan, Professor, Department of Obstetrics and Gynaecolgoy, King George Medical University Lucknow, Uttar Pradesh, India.
Professor, Department of Obstetrics and Gynaecolgoy, King George Medical University Lucknow, Uttar Pradesh, India.
Munna Lal Patel, Resident, Department of Obstetrics & Gynaecology, King George Medical University, Lucknow, Uttar Pradesh, India.
Resident, Department of Obstetrics & Gynaecology, King George Medical University, Lucknow, Uttar Pradesh, India.
Himani Chaudhary, Professor, Department of Medicine, King George Medical University Lucknow, Uttar Pradesh, India.
Professor, Department of Medicine, King George Medical University Lucknow, Uttar Pradesh, India.
Radhey Shyam, Additioanl Professor, Department of Geriatric Mental Health, King George Medical University Lucknow, Uttar Pradesh, India.
Additioanl Professor, Department of Geriatric Mental Health, King George Medical University Lucknow, Uttar Pradesh, India.
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