Profile and outcomes of women with pregnancy-related acute kidney injury requiring dialysis at a center in Ethiopia

Abstract

Objective: To describe the clinical profile and outcomes of women with pregnancy-related acute kidney injury (AKI) undergoing dialysis at Saint Paul's Hospital Millennium Medical College, Addis Ababa, where the first publicly funded large-scale dialysis service in Ethiopia was established.

Methods: In a hospital-based retrospective study, clinical records were reviewed for all women with pregnancy-related AKI attending the hemodialysis unit at the study center between August 2013 and July 2015.

Results: In total, 42 pregnant women with pregnancy-related AKI underwent dialysis. Their mean age was 28.9 ± 5.9 years. The most common cause of pregnancy-related AKI was pre-eclampsia or eclampsia (31/42, 74%), followed by puerperal sepsis (6/42, 14%). The mean number of dialysis sessions was 4.8 ± 4.6; the most common indication for dialysis was refractory fluid overload (35/42, 83%). Overall, 35 (83%) women were discharged with improvement, 5 (12%) died, and 2 (5%) absconded. Of the five maternal deaths, three women had pre-eclampsia-related AKI and two had puerperal sepsis-related AKI.

Conclusion: Hypertensive disorders of pregnancy were the leading cause of pregnancy-related AKI, which can be easily prevented with early diagnosis and timely intervention. Improving the quality of prenatal care to recognize hypertensive disorders during pregnancy, coupled with prompt management, might help to reduce maternal morbidity and mortality related to AKI.

Keywords: Acute kidney injury; Ethiopia; Hemodialysis; Pregnancy-related acute kidney injury.