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Medicina crítica (Colegio Mexicano de Medicina Crítica)
versão impressa ISSN 2448-8909
Resumo
ESTRADA-GUTIERREZ, Alfonso et al. Underdiagnosis of acute kidney injury in complicated obstetric patients in the Intensive Care Unit. Med. crít. (Col. Mex. Med. Crít.) [online]. 2021, vol.35, n.2, pp.79-83. Epub 25-Abr-2022. ISSN 2448-8909. https://doi.org/10.35366/99527.
Objective:
To define the prevalence and associated factors of acute renal injury in pregnancy (PR-AKI) in the Intensive Care Unit (ICU) of the Women’s Hospital, Morelia, Michoacán, Mexico.
Material and methods:
Retrospective, cross-sectional and descriptive study from January 2013-August 2018. Ambit: Intensive Care Unit of the Women’s Hospital. Patients: We reviewed 213 files of complicated obstetric patients. Inclusion criteria: complicated obstetric patients that merit admission to the ICU, patients who met criteria for LRA. Exclusion criteria: patients with chronic.
Main variables of interest: Complicated obstetric patients (preeclampsia, eclampsia, HELLP syndrome, hemorrhagic shock and sepsis). It was investigated if they developed PR-AKI.
Results:
154 complicated obstetric patients were included; an average of 25.6p ± 1.6 per year. 36% had a diagnosis of eclampsia; 35.3% pre-eclampsia; 29.3% HELLP syndrome; 19.3% obstetric hemorrhage, 10% sepsis. Association of PR-AKI with HELLP syndrome (p = 0.0003) and pre-eclampsia (p = 0.01) was demonstrated.
A subdiagnosis of 36.7% was found when searching for PR-AKI using the RIFLE and AKI criteria (p = 0.000007). Of the patients with PR-AKI grade 3, 20% required continuous renal replacement therapy.
Conclusions:
Renal injury associated with complicated pregnancy has a prevalence of 6.7%. The complications that most develop PR-AKI are HELLP syndrome and preeclampsia. PR-AKI is underdiagnosed.
Palavras-chave : Acute kidney injury; renal replacement therapy; intensive care unit; eclampsia; preeclampsia; HELLP syndrome.