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Pregnancy-related Acute Kidney Injury in pre-eclampsia: risk factors and renal outcomes

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Pregnancy-related Acute Kidney Injury in pre-eclampsia : risk factors and renal outcomes. / Conti-Ramsden, Frances I; Nathan, Hannah L; De Greeff, Annemarie; Hall, David R; Seed, Paul T; Chappell, Lucy C; Shennan, Andrew H; Bramham, K.

In: Hypertension, Vol. 74, No. 5, 11.2019, p. 1144–1151.

Research output: Contribution to journalArticle

Harvard

Conti-Ramsden, FI, Nathan, HL, De Greeff, A, Hall, DR, Seed, PT, Chappell, LC, Shennan, AH & Bramham, K 2019, 'Pregnancy-related Acute Kidney Injury in pre-eclampsia: risk factors and renal outcomes', Hypertension, vol. 74, no. 5, pp. 1144–1151. https://doi.org/10.1161/HYPERTENSIONAHA.119.13089

APA

Conti-Ramsden, F. I., Nathan, H. L., De Greeff, A., Hall, D. R., Seed, P. T., Chappell, L. C., ... Bramham, K. (2019). Pregnancy-related Acute Kidney Injury in pre-eclampsia: risk factors and renal outcomes. Hypertension, 74(5), 1144–1151. https://doi.org/10.1161/HYPERTENSIONAHA.119.13089

Vancouver

Conti-Ramsden FI, Nathan HL, De Greeff A, Hall DR, Seed PT, Chappell LC et al. Pregnancy-related Acute Kidney Injury in pre-eclampsia: risk factors and renal outcomes. Hypertension. 2019 Nov;74(5):1144–1151. https://doi.org/10.1161/HYPERTENSIONAHA.119.13089

Author

Conti-Ramsden, Frances I ; Nathan, Hannah L ; De Greeff, Annemarie ; Hall, David R ; Seed, Paul T ; Chappell, Lucy C ; Shennan, Andrew H ; Bramham, K. / Pregnancy-related Acute Kidney Injury in pre-eclampsia : risk factors and renal outcomes. In: Hypertension. 2019 ; Vol. 74, No. 5. pp. 1144–1151.

Bibtex Download

@article{c1d32ba44c654514bd0aeabc8d01b5d4,
title = "Pregnancy-related Acute Kidney Injury in pre-eclampsia: risk factors and renal outcomes",
abstract = "Preeclampsia is a common cause of acute kidney injury (AKI) in low- and middle-income countries, but AKI incidence in preeclampsia, its risk factors, and renal outcomes are unknown. A prospective observational multicenter study of women admitted with preeclampsia in South Africa was conducted. Creatinine concentrations were extracted from national laboratory databases for women with maximum creatinine of ≥90 μmol/L (≥1.02 mg/dL). Renal injury and recovery were defined by Kidney Disease Improving Global Outcomes creatinine criteria. Predefined risk factors, maternal outcomes, and neonatal outcomes were compared between AKI stages. Of 1547 women admitted with preeclampsia 237 (15.3{\%}) met AKI criteria: 6.9{\%} (n=107) stage 1, 4.3{\%} (n=67) stage 2, and 4.1{\%} (n=63) stage 3. There was a higher risk of maternal death (n=7; relative risk, 4.3; 95{\%} CI, 1.6–11.4) and stillbirth (n=80; relative risk, 2.2; 95{\%} CI, 1.8–2.8) in women with AKI compared with those without. Perinatal mortality was also increased (89 of 240; 37.1{\%}). Hypertension in a previous pregnancy was the strongest predictor of AKI stage 2 or 3 (odds ratio, 2.24; 95{\%} CI, 1.21–4.17). Renal recovery rate reduced with increasing AKI stage. A third of surviving women (76 of 230 [33.0{\%}]) had not recovered baseline renal function by discharge. Approximately half (39 of 76; 51.3{\%}) of these women had no further creatinine testing post-discharge. In summary, AKI was common in women with preeclampsia and had high rates of associated maternal and perinatal mortality. Only two-thirds of women had confirmed renal recovery. History of a previous hypertensive pregnancy was an important risk factor.",
keywords = "acute kidney injury, creatinine, preeclampsia, pregnancy, renal insufficiency, chronic",
author = "Conti-Ramsden, {Frances I} and Nathan, {Hannah L} and {De Greeff}, Annemarie and Hall, {David R} and Seed, {Paul T} and Chappell, {Lucy C} and Shennan, {Andrew H} and K Bramham",
year = "2019",
month = "11",
doi = "10.1161/HYPERTENSIONAHA.119.13089",
language = "English",
volume = "74",
pages = "1144–1151",
journal = "Hypertension",
issn = "0194-911X",
publisher = "American Heart Association, Inc.",
number = "5",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - Pregnancy-related Acute Kidney Injury in pre-eclampsia

T2 - risk factors and renal outcomes

AU - Conti-Ramsden, Frances I

AU - Nathan, Hannah L

AU - De Greeff, Annemarie

AU - Hall, David R

AU - Seed, Paul T

AU - Chappell, Lucy C

AU - Shennan, Andrew H

AU - Bramham, K

PY - 2019/11

Y1 - 2019/11

N2 - Preeclampsia is a common cause of acute kidney injury (AKI) in low- and middle-income countries, but AKI incidence in preeclampsia, its risk factors, and renal outcomes are unknown. A prospective observational multicenter study of women admitted with preeclampsia in South Africa was conducted. Creatinine concentrations were extracted from national laboratory databases for women with maximum creatinine of ≥90 μmol/L (≥1.02 mg/dL). Renal injury and recovery were defined by Kidney Disease Improving Global Outcomes creatinine criteria. Predefined risk factors, maternal outcomes, and neonatal outcomes were compared between AKI stages. Of 1547 women admitted with preeclampsia 237 (15.3%) met AKI criteria: 6.9% (n=107) stage 1, 4.3% (n=67) stage 2, and 4.1% (n=63) stage 3. There was a higher risk of maternal death (n=7; relative risk, 4.3; 95% CI, 1.6–11.4) and stillbirth (n=80; relative risk, 2.2; 95% CI, 1.8–2.8) in women with AKI compared with those without. Perinatal mortality was also increased (89 of 240; 37.1%). Hypertension in a previous pregnancy was the strongest predictor of AKI stage 2 or 3 (odds ratio, 2.24; 95% CI, 1.21–4.17). Renal recovery rate reduced with increasing AKI stage. A third of surviving women (76 of 230 [33.0%]) had not recovered baseline renal function by discharge. Approximately half (39 of 76; 51.3%) of these women had no further creatinine testing post-discharge. In summary, AKI was common in women with preeclampsia and had high rates of associated maternal and perinatal mortality. Only two-thirds of women had confirmed renal recovery. History of a previous hypertensive pregnancy was an important risk factor.

AB - Preeclampsia is a common cause of acute kidney injury (AKI) in low- and middle-income countries, but AKI incidence in preeclampsia, its risk factors, and renal outcomes are unknown. A prospective observational multicenter study of women admitted with preeclampsia in South Africa was conducted. Creatinine concentrations were extracted from national laboratory databases for women with maximum creatinine of ≥90 μmol/L (≥1.02 mg/dL). Renal injury and recovery were defined by Kidney Disease Improving Global Outcomes creatinine criteria. Predefined risk factors, maternal outcomes, and neonatal outcomes were compared between AKI stages. Of 1547 women admitted with preeclampsia 237 (15.3%) met AKI criteria: 6.9% (n=107) stage 1, 4.3% (n=67) stage 2, and 4.1% (n=63) stage 3. There was a higher risk of maternal death (n=7; relative risk, 4.3; 95% CI, 1.6–11.4) and stillbirth (n=80; relative risk, 2.2; 95% CI, 1.8–2.8) in women with AKI compared with those without. Perinatal mortality was also increased (89 of 240; 37.1%). Hypertension in a previous pregnancy was the strongest predictor of AKI stage 2 or 3 (odds ratio, 2.24; 95% CI, 1.21–4.17). Renal recovery rate reduced with increasing AKI stage. A third of surviving women (76 of 230 [33.0%]) had not recovered baseline renal function by discharge. Approximately half (39 of 76; 51.3%) of these women had no further creatinine testing post-discharge. In summary, AKI was common in women with preeclampsia and had high rates of associated maternal and perinatal mortality. Only two-thirds of women had confirmed renal recovery. History of a previous hypertensive pregnancy was an important risk factor.

KW - acute kidney injury

KW - creatinine

KW - preeclampsia

KW - pregnancy

KW - renal insufficiency, chronic

UR - http://www.scopus.com/inward/record.url?scp=85073124730&partnerID=8YFLogxK

U2 - 10.1161/HYPERTENSIONAHA.119.13089

DO - 10.1161/HYPERTENSIONAHA.119.13089

M3 - Article

C2 - 31564161

VL - 74

SP - 1144

EP - 1151

JO - Hypertension

JF - Hypertension

SN - 0194-911X

IS - 5

ER -

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