Korean Journal of Nephrology 2000;19(3):429-436.

원저 : 중증 전자간증 환자에서 동반되는 급성 신부전증의 임상적 특성에 관한 연구 (Clinical Characteristic of Acute Renal Failure in Patients with Severe Preeclampsia)

방병기(Byung Kee Bang),김영옥(Young Ok Kim),윤선애(Sun Ae Yoon),양철우(Chul Woo Yang),조재형(Jae Hyung Cho),권용일(Yong Il Kwon),권동진(Dong Jin Kwon),박태철(Tae Chul Park)

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(systolic:173±22 vs 164±19mmHg, p<0.02, diastolic:119±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 compli-cations such as syndrome of hemolysis, elevated liver enzymes, and low platelets(HELLP syndrome), abrup-tio 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 pre-eclampsia occur frequently in patients with history of chronic hypertension, twin pregnancy, severe hypertension, severe hypoalbuminemia, and thrombocytopenia.