Evidence map›Paper›PMID 32072506›Full record

ArticleJournal of nephrology2020

Pregnancy-related acute kidney injury: mortality and survival of patients treated at a maternal intensive care unit.

Dilson Palhares Ferreira, Fábio Ferreira Amorim, Amanda Jacomeli Matsuura, Jaqueline Lima de Sousa, Adriell Ramalho Santana, Juliana Ascenção de Souza, Aline Mizusaki Imoto

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In one paragraph

Article in Journal of nephrology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 2 pooled it
1.5field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 21 citations in OpenAlex.

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  10. Etiology of Pregnancy-related Acute Kidney Injury among Obstetric Patients in India: A Systematic Review.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Dilson Palhares FerreiraPrograma de Pós-Graduação Em Ciências Para a Saúde, Coordenação de Pós-Graduação E Extensão, Escola Superior de Ciências da Saúde (ESCS), SMHN Quadra 03, Conjunto A, Bloco 1, Edifício FEPECS Brasília, Brasília, DF, 70710-907, Brazil. palhares.dilson@gmail.com.ORCID http://orcid.org/0000-0002-4430-4984
Fábio Ferreira AmorimPrograma de Pós-Graduação Em Ciências Para a Saúde, Coordenação de Pós-Graduação E Extensão, Escola Superior de Ciências da Saúde (ESCS), SMHN Quadra 03, Conjunto A, Bloco 1, Edifício FEPECS Brasília, Brasília, DF, 70710-907, Brazil.
Amanda Jacomeli MatsuuraDepartamento de Nefrologia, Hospital de Base Do Distrito Federal, Brasília, Brazil.
Jaqueline Lima de SousaCurso de Graduação Em Medicina, Escola Superior de Ciências da Saúde (ESCS), Brasília, Brazil.
Adriell Ramalho SantanaCurso de Graduação Em Medicina, Escola Superior de Ciências da Saúde (ESCS), Brasília, Brazil.
Juliana Ascenção de SouzaUnidade de Terapia Intensiva Materna Do Hospital Materno Infantil de Brasília, Brasília, Brazil.
Aline Mizusaki ImotoPrograma de Pós-Graduação Em Ciências Para a Saúde, Coordenação de Pós-Graduação E Extensão, Escola Superior de Ciências da Saúde (ESCS), SMHN Quadra 03, Conjunto A, Bloco 1, Edifício FEPECS Brasília, Brasília, DF, 70710-907, Brazil.
Escola Superior de Ciências da Saúde · BRHospital de Base · BR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPregnancy-related acute kidney injury (AKI) can be defined as the abrupt decline in renal function during pregnancy or the postpartum period. It remains a relevant cause of fatal complications in obstetric patients. This study aimed to determine the incidence of pregnancy-related AKI in a maternal intensive care unit (ICU) as well as the associated risk factors for dialysis therapy and maternal mortality according to the KDIGO classification system.

methodsRetrospective analysis of observational data prospectively collected from January/2014 to April/2016 in a maternal ICU in a public tertiary maternal hospital in Brasília, Federal District, Brazil. All consecutive patients diagnosed with pregnancy-related AKI were included. Cases of renal failure before pregnancy or kidney transplantation were excluded.

resultsOf the 619 admitted patients, pregnancy-related AKI was present in 172 cases (27.8%). One hundred and ten patients were classified as KDIGO 1 (64.0%), 43 as KDIGO 2 (20.9%) and 22 as KDIGO 3 (15.1%). KDIGO stages 2 and 3 were less frequent than KDIGO stage 1 in patients with gestational hypertension (p = 0.0010). Thirteen patients required hemodialysis (7.6%). Higher APACHE II (p = 0.0399) and SOFA (p = 0.0297) scores, hypovolemic shock (p = 0.0189) and septic shock (p = 0.0204) were independently associated with dialysis therapy (hemodialysis in all cases), 15 patients died (8.7%). Time to death was shorter in patients with a higher KDIGO stage (p = 0.002). Norepinephrine (p = 0.0384) and hemodialysis therapy (p = 0.0128) were independently associated with maternal mortality.

conclusionsThe incidence of pregnancy-related AKI remains high in the maternal ICU setting. Septic shock, hypovolemic shock, and higher APACHE II and SOFA scores were independently associated dialysis therapy (hemodialysis in all cases). KDIGO stages 2 and 3 were less frequent than KDIGO stage 1 in patients with gestational hypertension. Norepinephrine and hemodialysis therapy were independently associated with maternal mortality in patients with pregnancy-related AKI. KDIGO stage 3 was associated with higher maternal mortality.

Indexed as

Acute Kidney InjuryIntensive Care UnitsAPACHEFemaleHospital MortalityHumansPregnancyRetrospective StudiesRisk FactorsAcute kidney injuryIntensive care unitsKDIGO criteriaMaternal deathPregnancy

Identifiers

PMID32072506
OpenAlexW3008640321

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.