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| Year : 2011 | Volume
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| Issue : 2 | Page : 352-353 |
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| Pregnancy-related acute renal failure: A ten-year experience |
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V Sivakumar, G Sivaramakrishna, VV Sainaresh, P Sriramnaveen, C Krihna Kishore, Ch Shoba Rani, K Jagadeesh
Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
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| Date of Web Publication | 18-Mar-2011 |
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How to cite this article:
Sivakumar V, Sivaramakrishna G, Sainaresh V V, Sriramnaveen P, Kishore C K, Rani CS, Jagadeesh K. Pregnancy-related acute renal failure: A ten-year experience. Saudi J Kidney Dis Transpl 2011;22:352-3 |
How to cite this URL:
Sivakumar V, Sivaramakrishna G, Sainaresh V V, Sriramnaveen P, Kishore C K, Rani CS, Jagadeesh K. Pregnancy-related acute renal failure: A ten-year experience. Saudi J Kidney Dis Transpl [serial online] 2011 [cited 2021 Apr 13];22:352-3. Available from: https://www.sjkdt.org/text.asp?2011/22/2/352/77635 |
To the Editor,
Acute renal failure is a rare but important complication during pregnancy. The incidence of pregnancy-related acute renal failure (PRARF) in the developed countries is 1-2.8%, whereas in the developing countries this is about 4.2- 15%. [1],[2],[3] Renal failure in pregnancy has a bimodal distribution, one peak occurring during the 7 th and 8 th weeks of pregnancy and a second peak occurring during the 32 nd and 36 th weeks of pregnancy. [3] Based on the trimester of pregnancy, PRARF is divided into three groups, viz. first half, second half and postpartum ARF. Septic abortion is the most common cause of ARF during the first half of pregnancy; pre-eclampsia or abruptio placenta are the causes in the second half of pregnancy while hemolytic uremic syndrome occurs in the postpartum period. [1]
Of 1353 patients of acute renal failure admitted to the nephrology department of our institute during 1999 to 2009, 59 patients (4.36%) were associated with pregnancy. The age range was 15-45 years, with a mean of 25.6 years. PRARF was seen in the postpartum period in 74.57%, in the third trimester in 16.94%, in the second trimester in 6.77% and in the first trimester in 1.69%. It followed normal delivery in 30.50% and cesarean section in 33.89%. The laboratory findings and the causes are given in a tabular form [Table 1] and [Table 2]. Dialysis support (HD 49.15%, CVVHD 6.77% and PD 3.38%) was needed in 59.32%. There was complete recovery in 54.23%, partial recovery in 10.16% and death in 23.72%. Over 11.86% left against medical advice. The frequency of PRARF reported from several Indian studies varied between 15% and 4.3% [Table 3]. [1],[2],[3],[4],[5],[6] In our present study, it was about 4.36%. Sepsis was found to be the major cause in producing PRARF. However, it was due to septic abortions and puerperal sepsis in several studies. [3],[5],[6] In our patients, it was predominantly due to puerperal sepsis. | Table 1: Laboratory findings in patients with pregnancy-related acute renal failure.
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 | Table 3: Prevalence of pregnancy-related acute renal failure in various studies.
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In conclusion, PRARF continues to be of significant occurrence, accounting for over 4.3% of the ARF in our study. Puerperal sepsis was the important cause (47.41%). Im provement in the care during the peripartum period will help in reducing PRARF.
 References | |  |
| 1. | Goplani KR, Shah PR, Gera DN, et al. Pregnancy related acute renal failure: A single center experience. Indian J Nephrol 2008;18 (1):17-21. 
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| 2. | Sunil Kumar K, Ramakrishna C, Sivakumar V. Pregnancy related acute renal failure. J Obstet Gynecol India 2006;56(4):308-10.
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| 3. | Chugh KS. Etiopathogenesis of acute renal failure in the tropics. Ann Natl Acad Med Sci (India) 1987;23(2):88-99.
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| 4. | Prakash J, Tripathi K, Malhotra V, et al. Acute renal failure in eastern India. Nephrol Dial Transplant 1995;10:2009-12.
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| 5. | Rani TU, Narayen G, Anuradha. Changing trends in pregnancy related acute renal failure. J Obstet Gynecol India 2002;52:36-8.
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| 6. | Saleem Najar M, Rashid Shah A, Wani IA, et al. Pregnancy related acute kidney injury: A single center experience from the Kashmir valley. Indian J Nephrol 2008;18(4):159-61.
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Correspondence Address:
V Sivakumar
Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh
India
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PMID: 21422644 
[Table 1], [Table 2], [Table 3] |
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| This article has been cited by | | 1 |
Community-acquired acute kidney injury in tropical countries |
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| Jha, V. and Parameswaran, S. | | Nature Reviews Nephrology. 2013; 9(5): 278-290 | | [Pubmed] | | | 2 |
Pregnancy related acute renal failure in a tertiary care hospital in Bangladesh |
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| Rahman, S. and Ratan, D.G. and Islam, N. and Das, A. and Shaha, A.K. and Khan, M.A.I. and Muhibur Rahman, M. | | Journal of Medicine (Bangladesh). 2012; 13(2): 129-132 | | [Pubmed] | | | 3 |
Acute kidney injury related to pregnancy in developing countries: Etiology and risk factors in an intensive care unit |
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| Bentata, Y. and Housni, B. and Mimouni, A. and Azzouzi, A. and Abouqal, R. | | Journal of Nephrology. 2012; 25(5): 764-775 | | [Pubmed] | |
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