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Year : 2013  |  Volume : 54  |  Issue : 3  |  Page : 191-195

Acute renal failure in pregnancy: Tertiary centre experience from north Indian population

1 Department of Internal Medicine (Nephrology Unit), King George's Medical University, Lucknow, Uttar Pradesh, India
2 Department of Obstetrics and Gynaecology, King George's Medical University, Lucknow, Uttar Pradesh, India
3 Department of Critical Care, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
4 Department of Physiology, King George's Medical University, Lucknow, Uttar Pradesh, India

Correspondence Address:
Munna Lal Patel
Department of Internal Medicine (Nephrology Unit), King George's Medical University, Lucknow C-28, Sec-J, Aliganj, Near Sangam Chauraha, Lucknow, Uttar Pradesh - 226 024
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Source of Support: Research Cell, King George's Medical University, Lucknow (Grant no.: 4078/R. Cell-10 dated 07/01/2010), Conflict of Interest: None

DOI: 10.4103/0300-1652.114586

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Background: Obstetrical acute renal failure ARF is now a rare entity in the developed countries but still a common occurrence in developing countries. Delay in the diagnosis and late referral is associated with increased mortality. This study aimed to evaluate the contributing factors responsible for pregnancy-related acute kidney failure, its relation with mortality and morbidity and outcome measures in these patients. Materials and Methods: Total 520 patients of ARF of various aetiology were admitted, out of these 60 (11.5%) patients were pregnancy-related acute renal failure. Results: ARF Acute renal failure occurred in 32 (53.3%) cases in early part of their pregnancy, whereas in 28 (46.7%) cases in later of the pregnancy. Thirty-two (53.3%) patients had not received any antenatal visit, and had home delivery, 20 (33.4%) patients had delivered in hospitals but without antenatal care and eight (13.3%) patients received antenatal care and delivered in the hospitals. Anuria was observed in 23 (38.3%) cases, remaining 37 (61.7%) cases presented with oliguria. Septicemia was present in 25 (41.7%), hypertensive disorder of pregnancy in 20 (33.3%), haemorrhage in eight (13.3%), abortion in 5 (8.3%), haemolysis elevated liver enzymes low platelets counts (HELLP) syndrome in one (1.67%) and disseminated intravascular coagulation in one (1.67%). (61.7%) patients were not dialyzed, 33 (55%) recovered normal renal function with conservative treatment. Complete recovery was observed in 45 (75%) patients, five (8.4%) patients developed irreversible renal failure. Maternal mortality was nine (15%) and foetal loss was 25 (41.7%). Conclusion: Pregnancy-related ARF is usually a consequence of obstetric complications; it carries very high morbidity and mortality.

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