Abstract:

Introduction Acute kidney injury results in devastating outcomes to affected patients and is reported to contribute to high morbidity and mortality rates disproportionately in lower- and middle-income countries. The causes of PRAKI are diverse, important ones being hemorrhage, hypertensive disorder in pregnancy and sepsis in developing countries.

Methods A retrospective study was conducted in the department of Obstetrics and Gynecology, at BMC Mwanza Tanzania, tertiary care hospital, from January to December 2023.Patients admitted to Obstetric unit, ICU, and dialysis unit, who were pregnant or less than 42 days postpartum, with acute kidney injury and required dialysis, were enrolled in the study and analyzed for prevalence, causes and outcome of PRAKI who underwent dialysis.

Results Patients developed AKI in the postpartum period 94.6% and 3.5% of those developed antenatally were in their second and third trimester, and 0.87% were in first trimister and majority women were multigravida 77.4% and mean age of 30. Patients who presented with AKI, 68 (59.1%) patients required dialysis, 59(86.8%) responded to dialysis and on an average, patients of PRAKI needed 6.5 cycles of dialysis. Most important causes was postpartum hemorrhage 52.9% seen in half of the patient,11.8% had HELLP syndrome,10.3% had eclampsia,8.8% had preeclampsia with severe feature and7.4% had sepsis, were 10.3% were co-existed causes. The frequency of persistent renal failure in PRAKI who underwent dialysis in this study was 30.9%, about 8.8% died and 60.3% of patients completely recovered. Prompt management and timely referral to a higher institute will decrease the incidence of PRAKI and its complications.