Prevalence and factors associated with acute kidney injury among women with preeclmapsia with severe features in Kawempe National Referral Hospital

Abstract

Background: Preeclampsia is one of the most common cause of pregnancy related Acute Kidney Injury (AKI) accounting for up to 30% of global cases. However, there is limited research conducted in Uganda on prevalence and factors associated with acute kidney injury among women with preeclampsia with severe features. This study aimed at establishing the prevalence and factors associated with AKI among women with preeclampsia with severe features at Kawempe National Referral Hospital. Methods: This was a cross sectional study of 196 pregnant women admitted in labour ward at Kawempe National Referral Hospital. A structured questionnaire was used to study factors associated with acute kidney injury. Preeclampsia with severe features was defined as blood pressure (≥140/90mmHg) and urine protein of 2+ on urine dipstick plus one or more of the following symptoms of severity (headache, epigastric pain, blurring of vision, convulsions) after 20 weeks of gestation in a previously normotensive patient or blood pressure ≥160/110 mmHg with or without proteinuria after 20 weeks of gestation in a previously normotensive patient. Acute kidney injury was diagnosed using KDIGO criteria of increase in serum creatinine ≥0.3 mg/dL within 48 hours or increase in serum creatinine ≥1.5 times baseline or urine volume <0.5 mL/kg/hour for 6 hours. Logistic regression analysis including bivariate and multivariate analysis was used to establish the factors associated with AKI with p<0.05 considered statistically significant. Results: The average age of the participants was 27.65 (±5.76). The prevalence of AKI was 15.31% (n=30), of which 70.0% (n=11/30) had stage 1 AKI, 26.7% (n=8/30) had stage 2 and one person (3.3%) had stage 3 AKI. AKI was found to be significantly associated with women who did not attend ANC (p=0.038), women who had APH in current pregnancy (p=0.024) and women who had severe thrombocytopenia (p=0.034).