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Objective: To evaluate renal complications of women managed for severe
preeclampsia at MTRH, Eldoret.
Design: Prospective cohort study.
Setting: Moi Teaching and Referral Hospital (MTRH), Eldoret
Participants: The study recruited 61 (exposed) women with severe preeclampsia
and 121 (non- exposed) women without severe preeclampsia all at ≥28 weeks
gestation.
Outcome: Acute kidney injury (AKI) and their outcomes which included
spontaneous kidney recovery, medical intervention without dialysis, need for
dialysis, need for continued dialysis at 6 weeks post-partum.
Results: Complete data for 175 participants (57 exposed and 118 non-exposed) was
available for analysis. Mean age was 28.57 (18-43) years. The incidence of AKI
among the exposed was 26.3% and 5.9% among the non-exposed. The exposed were
more likely to develop AKI than the non-exposed (RR 4.4 [95% CI 1.92 – 10.27]).
Among those who had AKI in the exposed group, 85.7% recovered with medical
intervention (without dialysis) while 14.3% underwent dialysis. History of
preeclampsia in previous pregnancy (RR 18.18[95% CI 2.26 – 157.95]) and diagnosis
of severe preeclampsia at <37 weeks gestation (RR 0.02 [95% CI 0.01 – 0.70]) were
statistically associated with AKI in severe preeclampsia.
Conclusion: Incidence of AKI in patients with severe preeclampsia was 26.3%.
Severe preeclampsia increased the risk of AKI 4.4 fold. Among those with AKI,
85.7% recovered with medical intervention while 14.3% underwent dialysis.in previous pregnancy and diagnosis of severe preeclampsia at <37 weeks
gestation.
Factors associated with AKI in severe preeclampsia were history of preeclampsia |
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