ArticleThe East African health research journal2024
Acute Kidney Injury: Magnitude and Predictors of Maternal Outcomes among Pre-Eclamptic and Eclamptic Women in Mwanza, Tanzania.
Article in The East African health research journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Acute kidney injury (AKI) that occurs during pregnancy or in the post-partum period is a serious obstetric complication with a significant risk of feto-maternal morbidity and mortality. Although globally there has been an overall decrease in the burden of pregnancy-related (PRAKI) AKI, recent studies show the increasing occurrence of this disease in Low-middle income countries (LMICs).This study was conducted to determine the magnitude and predictors of maternal outcomes of pre-eclamptic and eclamptic-related acute kidney injury at Bugando Medical Centre (BMC) and Sengerema Designated District Hospital (SDDH) Mwanza, Tanzania. Methods: A cohort study was conducted involving patients diagnosed with Preeclampsia-Eclampsia (PE-E) who were admitted at BMC and SDDH from November 2021 to June 2022. Data were collected through convenience sampling using a structured questionnaire. Statistical data analysis was performed using STATA version 15. A chi-square test was performed to test for significant associations between the predictor and outcome variables. A significant association was defined as a p-value of less than .05. Variables showing significant associations in the chi-square analysis were further analysed using multivariate logistic regression to evaluate the strength of the associations. Results: The study enrolled a total of 258 women with PE-E. The magnitude of AKI was found to be 141(54.7%,) out of 258 participants, of which Kidney Disease Improving Outcomes (KDIGO) stage 1 accounted for 103 (73%) stage 2, 20 (14.2%) and stage 3, were 18 (12.8%). Of these, 141 participants with AKI, 101 (71.6%) resolved within 7 days of delivery, 12 (8.5%) persisted beyond 7 days after delivery, and 28 (19.8%) worsened. Serum creatinine stages 2 and 3 at admission, HIV positive status, and informal education status were highly associated with persistent/worsening AKI stage. Conclusion: The magnitude of acute kidney injury was found to be high (54.7%) among pre-eclamptic and eclamptic patients in BMC and SDDH. AKI stages 2 and 3, HIV positive status and informal education level were associated with poor maternal outcomes mainly persistent AKI and worsening AKI.
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