Evidence map›Paper›PMID 38778267›Full record

ArticleBMC nephrology2024

Characteristics and outcome of pregnancy-related acute kidney injury in a teaching hospital in a low-resource setting: a five-year retrospective review.

Ephrem Berhe, Hale Teka, Hiluf Ebuy Abraha, Bisrat Tesfay Abera, Marta Abrha Gebru, Tsega Gebremariam, Mohammedtahir Yahya, Birhane Amare, Habtom Tadesse, Hagos Gidey and 4 more

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Article in BMC nephrology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

13 citing papers in PubMed, 1 synthesis or guideline pooled it.

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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

14 authors.

Ephrem BerheDepartment of Internal Medicine, Nephrology Unit, School of Medicine, Mekelle University, Mekelle, Tigray, Ethiopia. eph123ber@gmail.com.ORCID 0000-0002-6189-7988
Hale TekaDepartment of Obstetrics and Gynecology, School of Medicine, Mekelle University, Mekelle, Tigray, Ethiopia.
Hiluf Ebuy AbrahaDepartment of Biostatistics, School of Public Health, Mekelle University, Mekelle, Tigray, Ethiopia.
Bisrat Tesfay AberaDepartment of Internal Medicine, Nephrology Unit, School of Medicine, Mekelle University, Mekelle, Tigray, Ethiopia.
Marta Abrha GebruDepartment of Internal Medicine, Nephrology Unit, School of Medicine, Mekelle University, Mekelle, Tigray, Ethiopia.
Tsega GebremariamDepartment of Obstetrics and Gynecology, School of Medicine, Mekelle University, Mekelle, Tigray, Ethiopia.
Mohammedtahir YahyaDepartment of Obstetrics and Gynecology, School of Medicine, Mekelle University, Mekelle, Tigray, Ethiopia.
Birhane AmareDepartment of Obstetrics and Gynecology, School of Medicine, Mekelle University, Mekelle, Tigray, Ethiopia.
Habtom TadesseDepartment of Obstetrics and Gynecology, School of Medicine, Mekelle University, Mekelle, Tigray, Ethiopia.
Hagos GideyDepartment of Obstetrics and Gynecology, School of Medicine, Mekelle University, Mekelle, Tigray, Ethiopia.
Fireweyni TesfayDepartment of Obstetrics and Gynecology, School of Medicine, Mekelle University, Mekelle, Tigray, Ethiopia.
Mohamedawel Mohamedniguss EbrahimDepartment of Biostatistics, School of Public Health, Mekelle University, Mekelle, Tigray, Ethiopia.
Rahel KidanemariamDepartment of Obstetrics and Gynecology, School of Medicine, Mekelle University, Mekelle, Tigray, Ethiopia.
Awol Yemane LegesseDepartment of Obstetrics and Gynecology, School of Medicine, Mekelle University, Mekelle, Tigray, Ethiopia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPregnancy-related kidney injury contributes to a high burden of acute kidney injury in low-resource settings and causes maternal and perinatal morbidity and mortality. Few studies have examined the impact of acute kidney injury in resource-limited countries, with very limited research on pregnancy-specific disorders in Ethiopia. This study aimed to determine the characteristics of pregnancy-related acute kidney injury, outcomes and associated factors.

methodsA retrospective study was conducted to evaluate the clinical profile and maternal-fetal outcome of pregnancy-related acute kidney injury at Ayder Comprehensive Specialized Hospital in Tigray, Ethiopia, from January 1, 2017, to December 31, 2021. Maternal and fetal outcomes were analyzed using descriptive statistics. Multivariate logistic regression was used to determine the association between the dependent and independent variables.

resultsOf 27,350 mothers who delivered at Ayder Comprehensive Specialized Hospital between January 1, 2017, and December 31, 2021, a total of 187 women developed pregnancy-related acute kidney injury, a prevalence rate of 68 per 100,000 births. Preeclampsia, sepsis and pre-renal causes due to dehydration and hemorrhage were the most common causes of pregnancy-related acute kidney injury in this study. Hemodialysis was needed in 8.6% (n = 16) of patients. Of the 187 pregnancy-related acute kidney injuries, 143 (76.5%) recovered completely and 30 (16%) partially. The mortality rate was 7.5%. Preexisting chronic kidney disease (AOR = 30.13; 95% CI: 2.92, 310.84), use of vasoactive agents (AOR = 5.77; 95% CI: 1.47, 22.67), increase in creatinine per unit (AOR = 1.65; 95% CI: 1.11, 2.45) and complications related to acute kidney injury (AOR = 5.26; 95% CI: 1.73, 16.00) were determinants of the composite endpoints (partial renal recovery and death).

conclusionsThis study emphasizes acute kidney injury in resource-limited settings is a significant cause of maternal and fetal morbidity and mortality. The vast majority of patients with pregnancy-related acute kidney injury recovered completely from kidney injury. The main causes of pregnancy-related acute kidney injury were preeclampsia, sepsis and pre-renal associated with hemorrhage and dehydration. Preexisting renal disease, use of vasopressors, increase in creatinine per unit and complications associated with acute kidney injury were determining factors for concomitant fetomaternal mortality. Appropriate preventive strategies during prenatal care and prompt treatment are needed for pregnancy-related acute kidney injury.

Indexed as

Acute Kidney InjuryHospitals, TeachingPre-EclampsiaPregnancy ComplicationsAdultDehydrationDeveloping CountriesEthiopiaFemaleHumansInfant, NewbornPregnancyPregnancy OutcomePrevalenceRenal DialysisRetrospective StudiesDeterminant factorsEthiopiaOutcomePregnancy-related acute kidney injuryResource-limited setting

Identifiers

PMID38778267
PMCPMC11112934

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