An Evaluation of Risk Factors Associated with Pregnancy Related Acute Kidney Injury in Women Admitted to High Dependent Care Unit at Women And Newborn Hospital, Lusaka-Zambia.

Abstract

Objective: To evaluate factors associated with Pregnancy-related Kidney Injury (PRAKI) in women admitted to high dependent care unit at Women and Newborn Hospital in Lusaka, Zambia

Methodology: This was an unmatched case-control study conducted in the high-dependent care unit at Women and Newborn Hospital in Lusaka. Study participants were recruited consecutively by convenient sampling. Participants’ medical records were reviewed to capture serum creatinine levels; while a structured questionnaire was administered to eligible and consented study participants to capture data on sociodemographic, obstetric and medical factors. Serum creatinine levels above 84µmol/l were used as criteria for classifying PRAKI. Excel was used for data cleaning and Stata v13 used for analysis. Descriptive statistics were done for all variables followed by univariate and multivariable logistic regression to determine association. 95% CI was used and p value of <0.05 was considered significant.

Results: The study comprised of 185 study participants, split into 85 women with PRAKI (cases) and 100 women without PRAKI (controls). The median age was 29 years with 11years interquartile range. 75.3% (139) of the study participants were in marriage relationships. Pre-existing hypertension was the most prevalent medical condition in both the cases (51.8%) and the controls (38%). Sickle cell disease was much less common at 1.2% in cases and 8% in controls. Among the obstetric conditions, preeclampsia was the most prevalent condition at 77.6% and 60% in cases and controls respectively. Eclampsia was found in 38.8% of cases and 11% of controls. Sepsis was least common at 4.7% of cases. This study found that obstetric factors such as eclampsia (AOR = 5.12, 95% CI [2.14 – 12.23]; p≤0.0001), preeclampsia (AOR = 2.46, 95% CI [1.12 – 5.39]; p = 0.025), and postpartum haemorrhage were associated with the development of PRAKI. Medical conditions were not associated with PRAKI.

Conclusion: Thus the development of PRAKI was mainly associated obstetric factors such as eclampsia, preeclampsia, and post-partum haemorrhage.