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1.
Saudi J Kidney Dis Transpl ; 26(3): 619-24, 2015.
Article in English | MEDLINE | ID: mdl-26022044

ABSTRACT

Acute kidney injury (AKI) is a rare but life-threatening complication of pregnancy. The aim of this paper is to study the characteristics of acute AKI in pregnancy and to emphasize on its management modalities in Moroccan hospitals. This is a national prospective study performed over six months from July 1 to December 31 2010 on AKI developing in pregnant patients, both preand post-partum period. Patients with pre-existing kidney disease were excluded from the study. Outcome was considered unfavorable when complete recovery of renal function was not achieved and/or maternal death occurred. Forty-four patients were included in this study. They were 29.6 ± 6 years old and mostly illiterate (70.6%). Most AKI occurred in the post-partum period, with 66% of the cases occurring in those who did not receive antenatal care. The main etiologies were pre-eclampsia (28 cases), hemorrhagic shock (six cases) and septic events (five cases). We noted three cases of acute fatty liver, one case of obstructive kidney injury and one case of lupus nephritis. Hemodialysis was necessary in 17 (38.6%) cases. The outcome was favorable in 29 patients. The maternal mortality rate was 11.4%. Two poor prognostic factors were identified: Age over 38 years and sepsis. AKI is a severe complication of pregnancy in developing countries. Its prevention necessitates the improvement of the sanitary infrastructure and the establishment of the obligatory antenatal care.

2.
Nephrol Ther ; 5(2): 122-33, 2009 Apr.
Article in French | MEDLINE | ID: mdl-19013122

ABSTRACT

We report three original cases of sclerosing encapsulating peritonitis (SEP) which is a rare but severe complication of peritoneal dialysis (PD). In the report of case 1, SEP occurred in a 75-year-old diabetic patient mellitus 18 years after the arrest of PD technique recurrent infectious peritonitis. The switch to hemodialysis was associated with a chronic inflammatory state poorly explained until the discovery of SEP. For case 2, SEP started within seven months after automated PD initiation in a severe septic context leading to leg amputation in a 57-year-old unstable diabetic male. In the last case, 84-year-old woman presented SEP after several peritonitis episodes, including one due to acute pancreatitis. In all cases, SEP was confirmed by open surgery. All patients were treated by visceralysis. The outcome was favorable in two of these three patients. SEP mechanisms, risks factors, prognosis and treatment are discussed with reference to the literature.


Subject(s)
Peritoneal Dialysis/adverse effects , Peritonitis/etiology , Acute Disease , Adrenergic beta-Antagonists/adverse effects , Aged , Aged, 80 and over , Combined Modality Therapy , Comorbidity , Diabetes Mellitus, Type 2/complications , Fatal Outcome , Humans , Intestines/pathology , Kidney Failure, Chronic/complications , Kidney Failure, Chronic/therapy , Male , Pancreatitis/complications , Peritonitis/diagnosis , Peritonitis/microbiology , Peritonitis/pathology , Peritonitis/therapy , Postoperative Complications , Recurrence , Risk Factors , Sclerosis/etiology , Sclerosis/pathology
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