Acute kidney injury in pregnant patients under 20 years of age with severe pre-eclampsia. Experience in a high specialty hospital in Mexico City in 2018-2019

Objective: To determine the frequency, clinical course, treatment and outcome of acute kidney injury (AKI) in pregnant patients under 20 years of age with severe preeclampsia (SP). Material and method: Observational, cross-sectional, retrospective and analytical study in a series of 23 pregnant patients under 20 years of age with SP attended in the Intensive Care Unit (ICU) of a high specialty hospital in Mexico City during the years 2018 and 2019. Records were consulted to determine the frequency of patients that developed AKI (serum creatinine >= 1.1 mg/dL), complications, diuresis, drug treatment, replacement therapy, outcome (recovery, haemodialysis), and mortality. The results were compared with those of the patients in the series that did not present with an AKI. Descriptive statistics, Mann Whitney U test and Fisher's exact test, using SPSS version 20, were used. Results: Twenty-two patients had native kidneys and one had a kidney graft. The frequency of patients with AKI was 43.47% (n = 10) with mean serum creatinine 1.59 +/- 0.63 mg/dL (range 1.1 to 3.2) and urine volume 0.91 +/- 0.74 ml/kg/hour. All 23 patients received furosemide, as an individual drug intravenously 60.87% (n = 14), and 39.13% (n = 9) after the infusion of 0.9% NaCl solution. AKI recovered in 39.13% (n = 9), and haemodialysis was performed in the transplanted patient (4.34%), with 0% maternal death. Conclusions: The frequency of AKI was high with only one case requiring haemodialysis, and no maternal mortality. The unrestricted use of furosemide in all cases was relevant. (C) 2021 Elsevier Espana, S.L.U. All rights reserved.

Automated summary

This study aimed to investigate the frequency, clinical course, treatment and outcome of acute kidney injury in pregnant patients under 20 years of age with severe preeclampsia. The results showed a high frequency of AKI, with only one case requiring hemodialysis and no maternal mortality. The unrestricted use of furosemide in all cases was found to be relevant.