CHARACTERISTIC OF ACUTE KIDNEY INJURY IN SEVERE PREECLAMPLTIC INCIDENCE IN DR.

MOEWARDI SURAKARTA HOSPITAL INDONESIA

dr. Dinda Carissa, dr. Eric Edwin Yuliantara SpOG., Subsp. K.Fm

Department of Obstetrics and Gynecology, Faculty of Medicine Sebelas Maret

University/Dr. Moewardi General Hospital Surakarta, Indonesia

OBJECTIVE : Preeclampsia is one of the leading causes of maternal-fetal morbidity and death with 75%
of the cases causing acute kidney failure in pregnancy. Creatinine and urea serum are the most widely
used biomarkers of kidney function. Acute kidney failure in severely preeclamptic women will develop a
poor maternal outcome. This study presents the characteristic incidence of the Acute Kidney Injury in
Severe Preeclamptic Pregnant woman, which can be used as a reference for the outcome of pregnant
woman based on the severity of the AKIN caused by Severe Preeclampsia.

METHODS : It was a retrospective study with cross sectional design. This study was conducted in
Department of Obstetrics and Gynecology at Dr. Moewardi General Hospital, Surakarta. The data was
collected from electronic medical record from August 2021 – November 2022. The descriptive analysis
included median and frequency of the creatinine and urea levels, diagnosis, hemodialysis, and maternal
outcomes.

RESULTS : Forty seven complicated severe preeclamptic patients were enrolled in this study. Eight out of
47 patients (17,02%) reported underwent hemodialysis at least once to four times in a week. The mean
blood urea level was high (88.02 ± 52.86) with 34 (72.34%) patients had a high urea level and the mean
serum creatinine level was 15,02 (15.02 ± 21.98) with 35 (74.46%) patients had a high creatinine serum
level. Twenty out of 47 patients (42.55%) met Acute Kidney Injury (AKI) criteria with the first, second,
and third stage of AKI respectively (40% (n=8) ; 20%(n=4) ; 40% (n=8)). When it came to maternal
outcome, of the 47 patients, 8(17.02%) were reported with maternal death, while 17(36.17%) patients
were preterm, 19 (40.42%) patients were aterm and the other 3 patients (6.38%) were lost to follow up.
There was a higher risk of maternal death (n=8; relative risk, 5.3; 95%) and preterm birth (n=19; relative
risk, 3.2; 96%) in women with AKI compared with those without, thus half of the hemodialysis patients
underwent maternal death and preterm birth respectively (n=5, RR = 4.3; 95% ; n = 3, RR = 2.1; 85%).

CONCLUSION : This study observed a significantly higher concentration of creatinine serum and blood
urea values in pregnant women with severe preeclampsia. Therefore, this suggested that acute kidney
injury can be associated with severe PE. This study suggested that higher stage of AKI and hemodialysis
were associated with poor maternal outcome such as prematurity and maternal death.

Keyword : Creatinine, Urea, Severe preeclampsia, Maternal death, Prematurity.