Renal complications among women with severe preeclampsia managed at Moi Teaching and Referral Hospital, Eldoret, Kenya

Abstract

Objective: To evaluate renal complications of women managed for severe preeclampsia at MTRH, Eldoret.

Design: Prospective cohort study.

Setting: Moi Teaching and Referral Hospital (MTRH), Eldoret

Participants: The study recruited 61 (exposed) women with severe preeclampsia and 121 (non- exposed) women without severe preeclampsia all at ≥28 weeks gestation.

Outcome: Acute kidney injury (AKI) and their outcomes which included spontaneous kidney recovery, medical intervention without dialysis, need for dialysis, need for continued dialysis at 6 weeks post-partum.

Results: Complete data for 175 participants (57 exposed and 118 non-exposed) was available for analysis. Mean age was 28.57 (18-43) years. The incidence of AKI among the exposed was 26.3% and 5.9% among the non-exposed. The exposed were more likely to develop AKI than the non-exposed (RR 4.4 [95% CI 1.92 – 10.27]). Among those who had AKI in the exposed group, 85.7% recovered with medical intervention (without dialysis) while 14.3% underwent dialysis. History of preeclampsia in previous pregnancy (RR 18.18[95% CI 2.26 – 157.95]) and diagnosis of severe preeclampsia at <37 weeks gestation (RR 0.02 [95% CI 0.01 – 0.70]) were statistically associated with AKI in severe preeclampsia.

Conclusion: Incidence of AKI in patients with severe preeclampsia was 26.3%. Severe preeclampsia increased the risk of AKI 4.4 fold. Among those with AKI, 85.7% recovered with medical intervention while 14.3% underwent dialysis. Factors associated with AKI in severe preeclampsia were history of preeclampsia in previous pregnancy and diagnosis of severe preeclampsia at <37 weeks gestation.