Pregnancy-associated acute kidney injury as an important driver of chronic kidney disease in females in developing countries: A systematic review
Notice bibliographique
Résumé
INTRODUCTION: Pregnancy-related AKI (PR-AKI), has profound maternal and fetal implications, including high mortality and long-term risks such as the development of chronic kidney disease (CKD). This systematic review aims to evaluate the burden of CKD owing to PR-AKI cases during follow-up in developing countries, particularly India. METHODS: A systematic search of PubMed, Embase, and Cochrane databases was performed for Indian studies published between 2000 and June 2024. We included cross-sectional, retrospective, and prospective cohort studies that reported the incidence of PR-AKI, subsequent CKD, and dialysis dependency in Indian cohorts during follow-up. Details of etiology of PRAKI, and adverse fetal and maternal outcomes were also recorded. Only studies that provided follow-up kidney outcomes were considered. RESULTS: A total of 25 studies comprising 2,306 participants were included in the analysis. The incidence of PR-AKI ranged from 1 to 12% across different studies. Sepsis was the most common cause of PR-AKI, accounting for up to 78% of cases, followed by hypertensive disorders, obstetric haemorrhage, and tropical etiologies. Hemodialysis was required in 20-85% of patients. CKD development during follow-up was observed in 12.8-35% of cases, with up to 30% remaining dialysis-dependent. Maternal mortality ranged from 2.5 to 34%, while perinatal mortality reached as high as 67.3%. Pre-term delivery rates varied between 13.9% and 58%. CONCLUSIONS: Up to one-third of PR-AKI patients may develop CKD and remain dialysis-dependent during follow-up. PR-AKI significantly impacts both maternal and fetal morbidity and mortality. Early prevention and prompt management by healthcare professionals are critical to improving outcomes in PR-AKI. Pregnancy-related acute kidney injury (PR-AKI) significantly affects maternal and fetal health, leading to high mortality and long-term complications such as chronic kidney disease (CKD). This systematic review, focusing on developing countries like India, evaluated the burden of CKD due to PR-AKI patients. The review analyzed Indian studies published between 2000 and June 2024, including 25 studies with 2,306 participants. PR-AKI incidence ranged from 1 to 12%, with sepsis being the leading cause in up to 78% of cases, followed by hypertensive disorders, obstetric hemorrhage, and tropical fevers. RRT was needed in 20-85% of patients, and 12.8-35% developed CKD during follow-up, with up to 30% remaining dialysis-dependent. Maternal mortality varied from 2.5 to 34%, while perinatal mortality reached 67.3%. The study emphasizes the critical need for early prevention timely intervention and need for long-term follow-up to reduce the high morbidity and mortality rates associated with PR-AKI.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,009 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».