Demographic Characteristics and Risk Factors Affecting the Development of Postpartum Acute Kidney Injury in Somalia: Single-Center Experience

Nasteho Mohamed Sheikh Omar,1 Marian Muse Osman,2 Ifrah Adan Hilowle,3 Betul Erismis,4 Abdirahman Abdikadir Osman,5 Osman Abubakar Fiidow,6 Ahmed Muhammad Bashir5 1Department of Emergency Medicine, Mogadishu Somali Turkey Training and Research Hospital, Mogadishu, Somalia; 2Department of Public Health, Mogadishu Somali Turkey Training and Research Hospital, University of Health Sciences, Mogadishu, Somalia; 3Department of Education, Mogadishu Somali Turkey Training and Research Hospital, Mogadishu, Somalia; 4Department of Internal Medicine, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, University of Health Sciences, Istanbul, Turkey; 5Department of Internal Medicine, Mogadishu Somali Turkey Training and Research Hospital, Mogadishu, Somalia; 6School of Public Health and Research, Somali National University, Mogadishu, SomaliaCorrespondence: Ahmed Muhammad Bashir, Department of Internal Medicine, Mogadishu Somali Turkey Training and Research Hospital, Mogadishu, Somalia, Email ambashir@hotmail.comBackground and Aim: Although postpartum acute kidney injury (PPAKI) is declining in developing countries, it is still a leading cause of maternal and fetal morbidity and mortality. The study aimed to determine the causes, risk factors, and the outcomes of patients with postpartum acute kidney injury managed at Mogadishu Somali Turkey Training and Research Hospital, in Mogadishu, Somalia over a two years period.Methods: This study was conducted retrospectively at Mogadishu Somali-Turkey Training and Research Hospital, Somalia’s largest teaching and referral hospital. During a two-year period (January 2020 to December 2021), we evaluated women who had acute kidney injury during the postpartum period and were hospitalized in our hospital. The data was also evaluated for postpartum admission day and hospital stay. The requirement for dialysis and the results were documented. Maternal outcomes are categorized as follows: Complete recovery after discharge/follow-up, chronic dependence on hemodialysis and death during admission.Results: We studied 79 postpartum AKI patients. The mean age of the participants was 28.67 ± 6.14. Most patients (51%) were aged 20– 30, followed by 30– 40 (29%). According to self-reported comorbidities, most individuals had no history of chronic diseases, 8 (10.1%) had hypertension and 3 (3.8%) had heart failure, and DM and HTN 2(2.5%). The most common causes of PPAKI were eclampsia (24.1%), hemorrhagic shock, intrauterine mortality (16.5%), placenta abruptio and uterine rupture (8.9%). Hemorrhage (5.1%) and placenta previa (2.5%). The patient’s outcome was associated with age (p=0.04), platelet (p=0.024), and hospital stay (p=0.009).Conclusion: Postpartum acute kidney injury is very common in underdeveloped nations. Preeclampsia/Eclampsia, obstetric bleeding, and intrauterine death are the leading causes of postpartum acute kidney injury in Somalia. This tragic scenario may be avoided by providing appropriate antenatal care and raising awareness among Somali women about the benefits of antenatal care provided by public institutions.Keywords: postpartum AKI, pregnancy-related acute kidney injury, Somalia, eclampsia