Clinical Characteristic of Acute Renal Failure in Patients with Severe Preeclampsia / 대한신장학회잡지

ABSTRACT

To evaluate the risk factors and clinical characteristics of acute renal failure(ARF) in patients with severe preeclampsia, we retrospectively investigated medical and obstetric histories, clinical and laboratory findings, maternal morbidity, and perinatal outcome between renal insufficiency and normal groups in patients with severe preeclampsia. Of the total 307 patients with severe preeclampsia, ARF occurred in 36 patients and its incidence was 11.7%. ARF developed before labor in 17 patients and postpartum in 19 patients. Oliguria occurred in 13 patients(36.1%) and 3 out of these patients required hemodialysis. Of the 31 patients who was observed for 3 months, renal function did not recover in 3 patients(9.7%). The systolic and diastolic blood pressures in renal insufficiency group(n=36) were higher than those in normal group(systolic173+/-22 vs 164+/-19mmHg, p<0.02, diastolic119+/-17 vs 108+/-14mmHg, p<0.01). In addition to degree of blood pressure, this study demonstrated that the risk factors of acute renal failure at admission were history of chronic hypertension, twin pregnancy, hypoalbuminemia, and thrombocytopenia. The incidences of maternal complications such as syndrome of hemolysis, elevated liver enzymes, and low platelets(HELLP syndrome), abruptio placenta, pulmonary edema and perinatal morbidity in renal insufficiency group were higher than those in normal group, respectively. In conclusion, acute renal failure in severe preeclampsia occur frequently in patients with history of chronic hypertension, twin pregnancy, severe hypertension, severe hypoalbuminemia, and thrombocytopenia.