HELLP Syndrome Associated AKI -Single centered study from south India, a retrospective study was conducted to investigate the incidence, characteristics and clinical outcome of dengue viral infection with renal manifestations

Abstract

Background: Despite significant advances in obstetric management and therapeutics, pre eclampsia - eclampsia is still a serious complication of pregnancy with high morbidity and mortality. Approximately 10-20% of women with PIH have underlying HELLP Syndrome. HELLP Syndrome can have varied clinical presentations, including acute kidney injury (AKI). Methods: This is a retrospective, observational study. The study duration was from January 2002 to December 2015. Details regarding demographic characteristics, clinical profile, laboratory parameters, renal manifestations and outcome, maternal and fetal complications were studied. Results: A total of 79 patients were studied. HELLP syndrome occurred most commonly during the antenatal period (81%). AKI was seen in 32 patients (40.5%). Proteinuria was largely present but for 13 patients. Patients with HELLP syndrome were divided into 3 classes based on the Mississippi 2006 classification. Further analysis reveals incidence of AKI is more in Class 1 (81.25%) compared to the class II and class III, 12.50% and 6.25% respectively. Furthermore, when the incidence of AKI was analyzed, a total of 32 patients suffered from AKI of which 19 required renal replacement therapy. 25% of the patients who had AKI died. Conclusions: HELLP syndrome is one the important cause of maternal and perinatal morbidity and mortality. AKI in HELLP syndrome is quite common, it has to be diligently sort for has its treatment has serious implications for both short and long term morbidity and mortality of the mother and neonate.

Keywords

• HELLP syndrome
• Acute kidney injury
• Renal failure
• Dialysis
• Proteinuria