Associated factors of acute kidney injury during severe pre-eclampsia in Togo from 2019 to 2022: a case series study.

Background: Acute Kidney Injury (AKI) in pregnant women admitted for severe pre-eclampsia (PE) is common in developing countries. The aim of this study was to determine the frequency and associated factors of AKI in severe pre-eclampsia in Lomé.

Methods: A case series study was conducted from July 18, 2019, to August 17, 2022, at the Sylvanus Olympio University Hospital (CHU-SO) in Lomé, Togo. All pregnant women who were admitted with severe pre-eclampsia and had at least two measures of creatinine were included. AKI was defined according to the Kidney Disease Improving Global Outcomes (KDIGO) 2012 criteria.

Results: A total of 220 cases of severe preeclampsia were analysed during the study period. 44 cases of severe pre-eclampsia (20%) were complicated in AKI. The mean age of patients with AKI was 30 ± 5.40 years (versus 30.2 ± 6.94 years for patients without AKI). Factors associated with the occurrence of AKI in multivariate analysis were multigravidity (adjusted Odd Ratio [aOR] = 3.15, 95% CI, [1.16-8.57]); the presence of infectious syndrome (aOR = 2.69; 95% CI, [1.05-6.91]) and haemoglobin levels ≤ 10 g/dL (aOR: 2.76; 95% CI [1.34-5.69]). There were no maternal deaths.

Conclusions: The occurrence of AKI during severe preeclampsia is high at the CHU-SO in Lomé, Togo. The factors associated to AKI occurrence were multigravidity, infectious syndrome and haemoglobin level. Pregnant women with these factors should be closely monitored to avoid the occurrence of AKI.