Korean J Nephrol.  2006 Jul;25(4):579-586.

Clinical Characteristics in Patients with HELLP Syndrome Complicated with Acute Renal Failure

• Park JW
• Jin KS
• Yoo SJ
• Lee HH
• Chung WK
• Lee JS

Abstract

BACKGROUND: The aim of this study was to exam the clinical features and the renal outcome of HELLP syndrome complicated with ARF.
METHODS
Thirty-nine patients with HELLP syndrome were retrospectively analyzed on the basis of medical records. A serum creatinine level of >1.3 mg/dL was used as a criterion to define ARF for at least 48 hours.
RESULTS
Of the 39 patients, HELLP syndrome with ARF developed in 17 patients. The ARF group had a higher incidence of primigravida (p<0.05) and a longer gestational age at the onset of HELLP syndrome (p<0.05) than those in the non-ARF group. The recovery time of HELLP syndrome in the ARF group was much longer than that in the non-ARF group (p<0.05). In the ARF group, the serum aspartate aminotransferase (AST) concentration was higher (p<0.05) and the nadir blood platelet counts were lower (p<0.05). The incidence of disseminated intravascular coagulation (DIC) was significantly higher in the ARF group than in the non-ARF group (p<0.01). There was no significant difference in the incidence of pulmonary edema, abruptio placenta, preeclampsia, and fetal death between the two groups. Only one patient in the ARF group required hemodialysis. In all ARF patients, the renal impairment fully recovered within a median of 5 days (range: 2-32 days) after the onset of ARF.
CONCLUSION
The clinical factors associated with ARF in HELLP syndrome were primigravida, gestational age, serum AST level, blood platelet counts, and DIC. The ARF in HELLP syndrome fully recovered without progression to permanent renal impairment.

Keyword

Pregnancy; Acute renal failure

MeSH Terms

Acute Kidney Injury*
Aspartate Aminotransferases
Creatinine
Dacarbazine
Disseminated Intravascular Coagulation
Female
Fetal Death
Gestational Age
HELLP Syndrome*
Humans
Incidence
Medical Records
Placenta
Platelet Count
Pre-Eclampsia
Pregnancy
Pulmonary Edema
Renal Dialysis
Retrospective Studies
Aspartate Aminotransferases
Creatinine
Dacarbazine