Laboratory Indicators of AKI in the Setting of HELLP Syndrome in Resource-constrained Backgrounds

Collins Amadi; Bright Amadi

doi:doi:10.11648/j.ajlm.20210606.16

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Laboratory Indicators of AKI in the Setting of HELLP Syndrome in Resource-constrained Backgrounds

Collins Amadi, Bright Amadi

Published in American Journal of Laboratory Medicine (Volume 6, Issue 6)

Received: 23 November 2021 Accepted: 10 December 2021 Published: 24 December 2021

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Abstract

Background: Acute Kidney Injury (AKI) in the setting of HELLPs (HELLP syndrome) brings in a high rate of maternal and perinatal morbidity/mortality. Its diagnosis depends on proper evaluation of relevant laboratory indices; a factor that is very limited in resource-constrained environs. Hence, the current study evaluated some routine laboratory indices of AKI in the setting of HELLPs in resource-constrained backgrounds. Methods: The study was conducted retrospectively at a tertiary hospital in Nigeria among 198 pregnant women diagnosed/managed for HELLPs from 2011-2020. Relevant variables and data were extracted from laboratory and other medical files using a well-designed research pro forma and analyzed using standard guidelines. Results: Among those evaluated, 57.1% (n=115) developed AKI. The AKI cohorts had higher mean plasma creatinine (PCr) and plasma uric acid (PUA) levels but lower 24-hour urine volume (UV) compared to the non-AKI cohorts (p<0.05). PCr and PUA levels increased while 24-hour urine volume (UV) decreased with advancing AKI stages (p<0.05). The PCr, PUA, and 24-hour UV predicted AKI on univariate logistic regression analysis (LRA) (p<0.05). However, on multivariate LRA, PUA level and the 24-hour UV lost their statistical significance while that of PCr level was significantly amplified (OR: 9.440; 95%CI: 6.733-11.202). At a cut-off value of 106.7 µmol/L, PCr level maintained a robust predictive potential (AUC: 0.938; 95%CI: 0.859-1.000; p<0.001) for AKI. Conclusion: PCr had a robust predictive potential of AKI among the studied population. Hence, timely measurement of PCr level should be considered during the management of HELLPs to reduce the burden of AKI among this at-risk group, especially in resource-constrained settings.

Published in	American Journal of Laboratory Medicine (Volume 6, Issue 6)
DOI	10.11648/j.ajlm.20210606.16
Page(s)	114-119
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

HELLP, HELLPs, HELLP Syndrome, AKI

References

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APA Style

Collins Amadi, Bright Amadi. (2021). Laboratory Indicators of AKI in the Setting of HELLP Syndrome in Resource-constrained Backgrounds. American Journal of Laboratory Medicine, 6(6), 114-119. https://doi.org/10.11648/j.ajlm.20210606.16

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ACS Style

Collins Amadi; Bright Amadi. Laboratory Indicators of AKI in the Setting of HELLP Syndrome in Resource-constrained Backgrounds. Am. J. Lab. Med. 2021, 6(6), 114-119. doi: 10.11648/j.ajlm.20210606.16

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AMA Style

Collins Amadi, Bright Amadi. Laboratory Indicators of AKI in the Setting of HELLP Syndrome in Resource-constrained Backgrounds. Am J Lab Med. 2021;6(6):114-119. doi: 10.11648/j.ajlm.20210606.16

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@article{10.11648/j.ajlm.20210606.16,
  author = {Collins Amadi and Bright Amadi},
  title = {Laboratory Indicators of AKI in the Setting of HELLP Syndrome in Resource-constrained Backgrounds},
  journal = {American Journal of Laboratory Medicine},
  volume = {6},
  number = {6},
  pages = {114-119},
  doi = {10.11648/j.ajlm.20210606.16},
  url = {https://doi.org/10.11648/j.ajlm.20210606.16},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajlm.20210606.16},
  abstract = {Background: Acute Kidney Injury (AKI) in the setting of HELLPs (HELLP syndrome) brings in a high rate of maternal and perinatal morbidity/mortality. Its diagnosis depends on proper evaluation of relevant laboratory indices; a factor that is very limited in resource-constrained environs. Hence, the current study evaluated some routine laboratory indices of AKI in the setting of HELLPs in resource-constrained backgrounds. Methods: The study was conducted retrospectively at a tertiary hospital in Nigeria among 198 pregnant women diagnosed/managed for HELLPs from 2011-2020. Relevant variables and data were extracted from laboratory and other medical files using a well-designed research pro forma and analyzed using standard guidelines. Results: Among those evaluated, 57.1% (n=115) developed AKI. The AKI cohorts had higher mean plasma creatinine (PCr) and plasma uric acid (PUA) levels but lower 24-hour urine volume (UV) compared to the non-AKI cohorts (p<0.05). PCr and PUA levels increased while 24-hour urine volume (UV) decreased with advancing AKI stages (p<0.05). The PCr, PUA, and 24-hour UV predicted AKI on univariate logistic regression analysis (LRA) (p<0.05). However, on multivariate LRA, PUA level and the 24-hour UV lost their statistical significance while that of PCr level was significantly amplified (OR: 9.440; 95%CI: 6.733-11.202). At a cut-off value of 106.7 µmol/L, PCr level maintained a robust predictive potential (AUC: 0.938; 95%CI: 0.859-1.000; p<0.001) for AKI. Conclusion: PCr had a robust predictive potential of AKI among the studied population. Hence, timely measurement of PCr level should be considered during the management of HELLPs to reduce the burden of AKI among this at-risk group, especially in resource-constrained settings.},
 year = {2021}
}

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TY  - JOUR
T1  - Laboratory Indicators of AKI in the Setting of HELLP Syndrome in Resource-constrained Backgrounds
AU  - Collins Amadi
AU  - Bright Amadi
Y1  - 2021/12/24
PY  - 2021
N1  - https://doi.org/10.11648/j.ajlm.20210606.16
DO  - 10.11648/j.ajlm.20210606.16
T2  - American Journal of Laboratory Medicine
JF  - American Journal of Laboratory Medicine
JO  - American Journal of Laboratory Medicine
SP  - 114
EP  - 119
PB  - Science Publishing Group
SN  - 2575-386X
UR  - https://doi.org/10.11648/j.ajlm.20210606.16
AB  - Background: Acute Kidney Injury (AKI) in the setting of HELLPs (HELLP syndrome) brings in a high rate of maternal and perinatal morbidity/mortality. Its diagnosis depends on proper evaluation of relevant laboratory indices; a factor that is very limited in resource-constrained environs. Hence, the current study evaluated some routine laboratory indices of AKI in the setting of HELLPs in resource-constrained backgrounds. Methods: The study was conducted retrospectively at a tertiary hospital in Nigeria among 198 pregnant women diagnosed/managed for HELLPs from 2011-2020. Relevant variables and data were extracted from laboratory and other medical files using a well-designed research pro forma and analyzed using standard guidelines. Results: Among those evaluated, 57.1% (n=115) developed AKI. The AKI cohorts had higher mean plasma creatinine (PCr) and plasma uric acid (PUA) levels but lower 24-hour urine volume (UV) compared to the non-AKI cohorts (p<0.05). PCr and PUA levels increased while 24-hour urine volume (UV) decreased with advancing AKI stages (p<0.05). The PCr, PUA, and 24-hour UV predicted AKI on univariate logistic regression analysis (LRA) (p<0.05). However, on multivariate LRA, PUA level and the 24-hour UV lost their statistical significance while that of PCr level was significantly amplified (OR: 9.440; 95%CI: 6.733-11.202). At a cut-off value of 106.7 µmol/L, PCr level maintained a robust predictive potential (AUC: 0.938; 95%CI: 0.859-1.000; p<0.001) for AKI. Conclusion: PCr had a robust predictive potential of AKI among the studied population. Hence, timely measurement of PCr level should be considered during the management of HELLPs to reduce the burden of AKI among this at-risk group, especially in resource-constrained settings.
VL  - 6
IS  - 6
ER  -

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Author Information

Collins Amadi

Department of Chemical Pathology, Rivers State University, Port Harcourt, Nigeria
Bright Amadi

Department of Chemical Pathology, Rivers State University, Port Harcourt, Nigeria

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Collins Amadi, Bright Amadi. (2021). Laboratory Indicators of AKI in the Setting of HELLP Syndrome in Resource-constrained Backgrounds. American Journal of Laboratory Medicine, 6(6), 114-119. https://doi.org/10.11648/j.ajlm.20210606.16

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ACS Style

Collins Amadi; Bright Amadi. Laboratory Indicators of AKI in the Setting of HELLP Syndrome in Resource-constrained Backgrounds. Am. J. Lab. Med. 2021, 6(6), 114-119. doi: 10.11648/j.ajlm.20210606.16

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AMA Style

Collins Amadi, Bright Amadi. Laboratory Indicators of AKI in the Setting of HELLP Syndrome in Resource-constrained Backgrounds. Am J Lab Med. 2021;6(6):114-119. doi: 10.11648/j.ajlm.20210606.16

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@article{10.11648/j.ajlm.20210606.16,
  author = {Collins Amadi and Bright Amadi},
  title = {Laboratory Indicators of AKI in the Setting of HELLP Syndrome in Resource-constrained Backgrounds},
  journal = {American Journal of Laboratory Medicine},
  volume = {6},
  number = {6},
  pages = {114-119},
  doi = {10.11648/j.ajlm.20210606.16},
  url = {https://doi.org/10.11648/j.ajlm.20210606.16},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajlm.20210606.16},
  abstract = {Background: Acute Kidney Injury (AKI) in the setting of HELLPs (HELLP syndrome) brings in a high rate of maternal and perinatal morbidity/mortality. Its diagnosis depends on proper evaluation of relevant laboratory indices; a factor that is very limited in resource-constrained environs. Hence, the current study evaluated some routine laboratory indices of AKI in the setting of HELLPs in resource-constrained backgrounds. Methods: The study was conducted retrospectively at a tertiary hospital in Nigeria among 198 pregnant women diagnosed/managed for HELLPs from 2011-2020. Relevant variables and data were extracted from laboratory and other medical files using a well-designed research pro forma and analyzed using standard guidelines. Results: Among those evaluated, 57.1% (n=115) developed AKI. The AKI cohorts had higher mean plasma creatinine (PCr) and plasma uric acid (PUA) levels but lower 24-hour urine volume (UV) compared to the non-AKI cohorts (p<0.05). PCr and PUA levels increased while 24-hour urine volume (UV) decreased with advancing AKI stages (p<0.05). The PCr, PUA, and 24-hour UV predicted AKI on univariate logistic regression analysis (LRA) (p<0.05). However, on multivariate LRA, PUA level and the 24-hour UV lost their statistical significance while that of PCr level was significantly amplified (OR: 9.440; 95%CI: 6.733-11.202). At a cut-off value of 106.7 µmol/L, PCr level maintained a robust predictive potential (AUC: 0.938; 95%CI: 0.859-1.000; p<0.001) for AKI. Conclusion: PCr had a robust predictive potential of AKI among the studied population. Hence, timely measurement of PCr level should be considered during the management of HELLPs to reduce the burden of AKI among this at-risk group, especially in resource-constrained settings.},
 year = {2021}
}

Copy | Download

TY  - JOUR
T1  - Laboratory Indicators of AKI in the Setting of HELLP Syndrome in Resource-constrained Backgrounds
AU  - Collins Amadi
AU  - Bright Amadi
Y1  - 2021/12/24
PY  - 2021
N1  - https://doi.org/10.11648/j.ajlm.20210606.16
DO  - 10.11648/j.ajlm.20210606.16
T2  - American Journal of Laboratory Medicine
JF  - American Journal of Laboratory Medicine
JO  - American Journal of Laboratory Medicine
SP  - 114
EP  - 119
PB  - Science Publishing Group
SN  - 2575-386X
UR  - https://doi.org/10.11648/j.ajlm.20210606.16
AB  - Background: Acute Kidney Injury (AKI) in the setting of HELLPs (HELLP syndrome) brings in a high rate of maternal and perinatal morbidity/mortality. Its diagnosis depends on proper evaluation of relevant laboratory indices; a factor that is very limited in resource-constrained environs. Hence, the current study evaluated some routine laboratory indices of AKI in the setting of HELLPs in resource-constrained backgrounds. Methods: The study was conducted retrospectively at a tertiary hospital in Nigeria among 198 pregnant women diagnosed/managed for HELLPs from 2011-2020. Relevant variables and data were extracted from laboratory and other medical files using a well-designed research pro forma and analyzed using standard guidelines. Results: Among those evaluated, 57.1% (n=115) developed AKI. The AKI cohorts had higher mean plasma creatinine (PCr) and plasma uric acid (PUA) levels but lower 24-hour urine volume (UV) compared to the non-AKI cohorts (p<0.05). PCr and PUA levels increased while 24-hour urine volume (UV) decreased with advancing AKI stages (p<0.05). The PCr, PUA, and 24-hour UV predicted AKI on univariate logistic regression analysis (LRA) (p<0.05). However, on multivariate LRA, PUA level and the 24-hour UV lost their statistical significance while that of PCr level was significantly amplified (OR: 9.440; 95%CI: 6.733-11.202). At a cut-off value of 106.7 µmol/L, PCr level maintained a robust predictive potential (AUC: 0.938; 95%CI: 0.859-1.000; p<0.001) for AKI. Conclusion: PCr had a robust predictive potential of AKI among the studied population. Hence, timely measurement of PCr level should be considered during the management of HELLPs to reduce the burden of AKI among this at-risk group, especially in resource-constrained settings.
VL  - 6
IS  - 6
ER  -

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