Pregnancy-related acute kidney injury: Etiologies and short-term outcomes in a tertiary hospital in Southwest Nigeria.

Pregnancy-related acute kidney injury: Etiologies and short-term outcomes in a tertiary hospital in Southwest Nigeria. Saudi J Kidney Dis Transpl. 2019 Nov-Dec;30(6):1423-1430 Authors: Adejumo OA, Akinbodewa AA, Enikuomehin OC, Lawal OM, Abolarin OS, Alli OE Abstract Although the incidence of pregnancy-related acute kidney injury (PRAKI) is declining in developing countries, it still remains a major cause of maternal and fetal morbidity and mortality. The aim of this study was to determine the etiologies, short-term outcomes, and their predictors in patients with PRAKI managed in a tertiary health facility in Southwest Nigeria over a four-year period. This was a four-year retrospective review of clinical records of patients managed for PRAKI in University of Medical Sciences Teaching Hospital, Ondo State, Nigeria. Thirty-two women with a mean age of 31.09 ± 7.50 years had PRAKI during the period reviewed. Twenty-four (75%) patients were multiparous and PRAKI was most common in the postpartum period (56.3%). Twenty-three patients (71.9%) were in RIFLE Stage 3, 24 (75%) received blood transfusion, 5 (15.6%) required intensive care unit (ICU) care, 24 (75%) needed dialysis while 19 (59.4%) had hemodialysis. The common causes of PRAKI were obstetric hemorrhage in 16 (50%), sepsis in seven (21.9%), and eclampsia in six (18.8%). Maternal and fetal mortality were 34.4% and 50% respectively. Seventeen (53.1%) had full renal recovery and only one (3.1%) be...
Source: Saudi Journal of Kidney Diseases and Transplantation - Category: Urology & Nephrology Authors: Tags: Saudi J Kidney Dis Transpl Source Type: research

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Following successful kidney transplantation, recipients usually regain fertility. Post-engraftment pregnancies should be planned and the teratogenic mycophenolic acid should be replaced with azathioprine before conception. To avoid unintentional pregnancies, pre-conception counseling is mandatory in women of reproductive age who are scheduled for a kidney transplant. Counseling should be repeated after transplantation. Female recipients should receive advice to use long-acting reversible contraception and avoid pregnancy for a minimum of 1 year following transplantation. Conception should be deferred even longer in female ...
Source: Transplantation - Category: Transplant Surgery Tags: Review Source Type: research
Abstract 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 3...
Source: Saudi Journal of Kidney Diseases and Transplantation - Category: Urology & Nephrology Authors: Tags: Saudi J Kidney Dis Transpl Source Type: research
Abstract Objective To assess maternal and perinatal outcomes in pregnancies after kidney transplantation in a tertiary center in Brazil. Methods Retrospective cohort of pregnancies in women with kidney transplantation at the Universidade Estadual de Campinas, from January 1995 until December 2017. Medical charts were reviewed, andmaternal and perinatal outcomes were described as means and frequencies. Renal function and blood pressure were evaluated during pregnancy and postpartum. Results A total of 22 women had at least 1 pregnancy during the considered timeinterval, and 3 of them had> 1 pregnancy, totalizing 25 pregn...
Source: Revista Brasileira de Ginecologia e Obstetricia - Category: OBGYN Source Type: research
Conclusions In both mouse and human, uNK cells are the most prominent immune cells that occupy the maternal-fetal interface. The uNK cells appear to engage and establish complex interactions with the surrounding tissue, which impact their function. As more cell subsets are identified within the heterogeneous uNK cell population, it is anticipated that their functional heterogeneity will extend beyond vascular modification, growth-promotion and memory generation. Author Contributions DS wrote the manuscript. LY provided the micrographs and WY edited the manuscript. Funding Work in the Yokoyama lab on uterine NK cells i...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
We examined the risk of adverse pregnancy outcomes in primiparous kidney donors compared to matched controls.MethodsFifty ‐nine women with a history of kidney donation prior to their first pregnancy with normal renal function and no history of kidney disease, diabetes or chronic hypertension were matched 1:4 by age (within 2 years) and race to women with two kidneys using data from an integrated healthcare delivery s ystem. Adverse pregnancy outcomes were defined as preterm delivery (delivery 3 days, infant death/transfer to acute facility and low birth weight (
Source: Clinical Transplantation - Category: Transplant Surgery Authors: Tags: Original Article Source Type: research
AbstractPurpose of ReviewTo review the studies and practice guidelines on the preeclampsia risks in kidney donors and recipients.Recent FindingsThere is a small increased risk of gestational hypertension and preeclampsia in pregnancies that follow kidney donation. Kidney Disease Improving Global Outcomes (KDIGO) Clinical Practice Guideline (2017) and the 2015 American Society of Transplantation (AST) consensus conference statement recommends counseling kidney donors about this increased risk. There is no observed increase in fetal complications or eclampsia post-kidney donation. Preeclampsia is more commonly observed in ki...
Source: Current Hypertension Reports - Category: Primary Care Source Type: research
ABSTRACT Background: Liver transplantation (LT) is a successful treatment for both acute liver failure and end‐stage liver disease. The number of women of reproductive age undergoing LT is increasing. Pregnancy outcomes are favourable but there is still a lack of prognostic markers. We aimed to identify factors predictive of adverse pregnancy outcomes in LT recipients. Methods: An analysis of all pregnancies occurring in LT recipients from 1989‐2016 at King's College Hospital was performed. Clinical data of 162 conceptions in 93 women was reviewed. Descriptive and regression analyses were done to examine associations b...
Source: Liver Transplantation - Category: Transplant Surgery Authors: Tags: Original Article Source Type: research
ConclusionsKT pregnancies remain at high risk of obstetric complications, particularly pre‐eclampsia. Pre‐pregnancy graft function can be used to predict risk of adverse pregnancy outcomes and deterioration in graft function during and after delivery.This article is protected by copyright. All rights reserved.
Source: Clinical Transplantation - Category: Transplant Surgery Authors: Tags: Original Article Source Type: research
In this study, we found a low rate of preeclampsia in a low-to-moderate risk cohort, with an incidence of AKI and maternal mortality consistent with reported literature. PMID: 28352008 [PubMed - in process]
Source: Saudi Journal of Kidney Diseases and Transplantation - Category: Urology & Nephrology Authors: Tags: Saudi J Kidney Dis Transpl Source Type: research
Conclusions Eculizumab therapy during pregnancy displayed no overt safety issues but did not appear to prevent HELLP syndrome or pre-eclampsia in these high-risk chronic kidney disease patients.
Source: Nephrology Dialysis Transplantation - Category: Urology & Nephrology Authors: Tags: Intra- and Extracorporeal Treatments of Kidney Failure Source Type: research
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