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Changing epidemiology of acute kidney injury in pregnancy : a journey of four decades from a developing country
Joint Authors
Prakash, Suraj
Ganiger, Vivek C.
Prakash, Jai
Source
Saudi Journal of Kidney Diseases and Transplantation
Issue
Vol. 30, Issue 5 (31 Oct. 2019), pp.1118-1130, 13 p.
Publisher
Saudi Center for Organ Transplantation
Publication Date
2019-10-31
Country of Publication
Saudi Arabia
No. of Pages
13
Main Subjects
Abstract EN
-The incidence of acute kidney injury in pregnancy (P-AKI) has markedly decreased over the last three decades in India, particularly due to decreased incidence of postabortion AKI.
However, P-AKI still accounts for 3%–5% of cases of total AKI.
Postabortion sepsis has decreased to between 0.9% and 1.5% in 2014 from 9.4% in 1980–1990 in the new millennium.
Currently, in India, majority of P-AKI (70%–90%) occurs in the postpartum period and in late 3rd trimester similar to the developed countries, but causes are different.
We observed that preeclampsia/eclampsia is the most common cause of P-AKI in the late 3rd trimester and postpartum period followed by puerperal sepsis and postpartum hemorrhage (PPH).
Both puerperal sepsis and PPH are treatable and preventable etiologies of P-AKI.
Timely and aggressive management of antepartum hemorrhage (APH/PPH) and puerperal sepsis are required to reduce the burden of P-AKI in developing countries.
Specific-pregnancy disorders such as PaHUS/ thrombotic thrombocytopenic purpura, pregnancy-associated thrombotic microangiopathy, and acute fatty liver of pregnancy are the uncommon/rare causes of P-AKI in India and possibly also because of the lack of awareness toward diagnosis.
Despite decreasing incidence of P-AKI, fetal mortality remained high and unchanged.
However, maternal mortality has decreased to 5% from initial high mortality of 20%–25%.
The incidence and severity of renal cortical necrosis have significantly decreased at our center.
American Psychological Association (APA)
Prakash, Jai& Prakash, Suraj& Ganiger, Vivek C.. 2019. Changing epidemiology of acute kidney injury in pregnancy : a journey of four decades from a developing country. Saudi Journal of Kidney Diseases and Transplantation،Vol. 30, no. 5, pp.1118-1130.
https://search.emarefa.net/detail/BIM-1256160
Modern Language Association (MLA)
Prakash, Jai…[et al.]. Changing epidemiology of acute kidney injury in pregnancy : a journey of four decades from a developing country. Saudi Journal of Kidney Diseases and Transplantation Vol. 30, no. 5 (Sep. / Oct. 2019), pp.1118-1130.
https://search.emarefa.net/detail/BIM-1256160
American Medical Association (AMA)
Prakash, Jai& Prakash, Suraj& Ganiger, Vivek C.. Changing epidemiology of acute kidney injury in pregnancy : a journey of four decades from a developing country. Saudi Journal of Kidney Diseases and Transplantation. 2019. Vol. 30, no. 5, pp.1118-1130.
https://search.emarefa.net/detail/BIM-1256160
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references : p. 1127-1130
Record ID
BIM-1256160