Acute kidney injury in patients with eclampsia

Acute kidney injury is a serious complication of pregnancy whose frequency and adverse effects may be greater in eclampsia.

To determine the frequency, clinical evolution, treatment and outcome of acute kidney injury in patients with eclampsia.

Observational, cross-sectional, retrospective and analytical study. It included a series of 23 pregnant patients with eclampsia from the intensive care unit. Cases with acute kidney injury (serum creatinine > 1.1 mg/dL) were identified to document their frequency, clinical presentation, laboratory data, need for dialysis and outcome. Descriptive and inferential statistics (Wilcoxon test) were used for the analysis. A p value < 0.05 was significant.

The maternal age was 26.43 ± 5.43 years, with a pregnancy of 34.08 ± 3.04 weeks. Seizures occurred in the prepartum period in 69.56%, postpartum 26.09% and both 4.35%. The pre and post-seizure blood pressure showed differences (systolic 155.22 ± 17.80 mmHg vs. 139.13 ± 20.5 mmHg, p < 0.001; diastolic 97.65 ± 22.91 mmHg vs. 89.22 ± 17.81 mmHg, p = 0.010; mean 114.70 ± 24.21 mmHg vs. 105.60 ± 18.01 mmHg, p = 0.003). Pre-seizures creatinine was 0.95 ± 0.26 mg/dL and post-seizures 1.32 ± 0.37 mg/dL (p < 0.001). The frequency of acute kidney injury pre-seizures was 26.08% (6 cases, creatinine 1.30 ± 0.11 mg/dL) and post-seizures 56.52% (13 cases, creatinine 1.55 ± 0.34 mg/dL) (p = 0.026).

The frequency of acute kidney injury increased after the seizures. The intensive care unit stay was prolonged, but without the need for dialysis and without effects on mortality.