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  3. Clinical Audit of Acute Kidney Injury in Critically Ill Obstetric Pati…
Original Article Open Access

Clinical Audit of Acute Kidney Injury in Critically Ill Obstetric Patients

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Annals of Medicine and Medical Sciences Volume 04 (2025), Version 10 August 17, 2025 pp. 928 - 933
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Abstract

Background: Pregnancy-related acute kidney injury (PRAKI) has a bimodal distribution. Study aimed to analyze epidemiological factors causing AKI in critically ill obstetric women and required early interventions. Materials and Methods: The study was conducted in an Obstetrics intensive care unit over a year. Total 447 obstetric patients admitted in critical care unit were recruited, 162 critically ill women who developed AKI were enrolled and followed for 3 months for renal outcome, AKI defined as per KDIGO guidelines. Data was collected through a structured questionnaire, medical records, and daily follow-ups until discharge. Analyses included ABG, complete blood count, serum urea, creatinine, PT/INR, and electrolytes. Critical illness was evaluated using the APACHE II score. Results: AKI incidence was 36.2%, hypertensive pregnancy disorders being the major cause (50.6%). Sepsis was most common mortality factor (27.16%), followed by hemorrhage (20.73%). 19.4% women died. Those patients who developed AKI, 70% recovered completely, 6.4% partially, 4.4% progressed to end stage renal disease. 71.6% cases of AKI were of antenatal. After 3 months of follow up, complete recovery significantly higher in Stage I AKI (96.4%) and Stage-II (81.3%) while rate of partial recovery and deaths were higher in Stage III AKI vs stage II (36.8%&15.8%). Higher APACHE II score (19.72±5.00) was associated with stage III AKI. Duration of ICU stay (4.56±4.82), duration of intubation (3.74±5.31) and requirement of vasopressor support significantly associated with adverse outcome. Conclusion: Higher stages of acute kidney injury (AKI) resulted in higher mortality, morbidity, APACHE II score, intervention and intubation requirements, and ICU stay.

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