Syed Rizwan Ali Bokhari, Syed Arsalan Khalid, Nida Nadeem, Sidra Saleem, Zumar Sardar, Ayesha Malik, Abeera Mansur.
Depression; Prevalence And Severity Of Depression Among Patients With Pregnancy Related Acute Kidney Injury Presenting To A Tertiary Care Hospital Of A Developing Country.
Professional Med J Jan ;24(6):904-11.

Background: Acute kidney injury (AKI) in pregnant women is commonly seen in developing countries. It is associated with significant morbidity, social and personal implications. We conducted a study to assess the prevalence and severity of depression in patients with pregnancy related AKI (PRAKI) in a tertiary care center. Methodology: Patients with PRAKI admitted from 1-16 to 6-16 under Nephrology service, Jinnah Hospital, Lahore were included in this cross-sectional study. The Hamilton Rating scale for depression (HAM-D) version translated and adapted in Urdu, was used to assess the study population. These patients were interviewed with the HAM-D questionnaire on their first encounter with Nephrology department. Previous history of psychiatric illness was excluded. The diagnosis of AKI was based on the classification of the Acute Kidney Injury Network group. Results: The mean age of the patients was 24±5 years. Seventeen (57%) patients were multipara and 13(43%) patients were primigravida. Of the 30 patients with AKI, 8 (27%) presented before 28 weeks and 22 (63%) presented after 28 weeks of gestation. The causes of AKI included postpartum hemorrhage in 9 (30%), sepsis in 8 (27%), preeclampsia/eclampsia in 6(20%), shock in 4 (13%) and coagulopathy in 3 (10%) patients. Alive and healthy fetus was found in only 15 (50%) patients. Twenty-one (70%) patients received average of 5-8 hemodialysis sessions during their hospital stay. Twenty-three (76%) had no depression (0-7 score), 2 (7%) had mild (8-13 score), 3 (10%) had moderate (14-18 score) and 2 (7%) had severe (19-22 score) depression according to HAM-D score. Conclusions: Our study depicted considerable depression of varying degrees in women with PRAKI, increased awareness and effective monitoring for depression should be integrated into regular maternal care to decrease morbidity associated with it.

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