Acute renal failure and pregnancy: a seventeen-year experience of a Tunisian intensive care unit

Abstract

Purpose: To describe the epidemiologic features of acute renal failure related to pregnancy (PRARF) and to evaluate its prognostic impact. Methods: Retrospective study conducted in a Tunisian intensive care unit over a period of 17 years (1995–2011). Women were included if they were more than 20 weeks pregnant and were admitted to the ICU during pregnancy or immediately (<7?d) post partum. PRARF was defined by a serum creatinine level >0.8?mg/dL and was classified as mild (0.9 to 1.4?mg/dL), moderate (1.5 to 2.9?mg/dL) or severe (>3?mg/dL). Results: Five hundred and fifty patients were included. Mean age was 31?±?6 years. Mean SOFA score was 4?±?3. PRARF was diagnosed in 313 patients (56.9%). ARF was mild in 215 cases (39.1%), moderate in 65 cases (11.8%) and severe in 33 cases (6%). Main causes leading to this complication were preeclampsia (66.5%) and acute hemorrhage (27.8%). Only two patients (0.4%) developed chronic renal failure and needed long-term dialysis. Patients who developed this complication had higher SOFA score (4.7?±?3.5 vs. 3.2?±?2.1; p?p?Conclusions: PRARF is associated with higher mortality. Thus, appropriate monitoring of pregnancies is needed in order to prevent its onset by an early and prompt management of the underlying risk factors.