MAGNITUDE OF ACUTE KIDNEY INJURY AND ITS DETERMINANTS AMONG OBSTETRIC PATIENTS ADMITTED TO OBSTETRIC HIGH DEPENDENCY UNIT OF ST PAUL’S HOSPITAL MILLENNIUM MEDICAL COLLEGE, ADDIS ABABA, ETHIOPIA, 2026

Abstract

Abstract Background: Acute kidney injury poses a significant threat to maternal health, especially among obstetric patients, who are vulnerable due to pregnancy-related physiological changes and complications like preeclampsia, sepsis, and hemorrhage. The global burden of AKI in obstetrics remains substantial, with higher prevalence rates reported in low- and middle-income countries due to limited access to healthcare. Pregnant women's predisposing factors include hypertensive disorders, sepsis, and obstetric hemorrhage. Objective: the aim of this study is to assess the magnitude of acute kidney injury and its determinants among obstetric patients admitted to obstetric high dependency unit of st Paul’s hospital millennium medical college, Addis Ababa, Ethiopia, Methods: An institutional based cross-sectional study was conducted. A total of 142 medical records of obstetric patients admitted to the OHDU of SPHMMC from September 1, 2024, to August 31, 2025 (Gregorian Calendar), were selected by systematic random sampling from HDU registration book. The data was coded and entered by Epi info and analysed with SPSS version 26 software packages, then using descriptive and statistics such as mean and standard deviation then the binary regression performed and a variable with a p-value <= 0.20 was included in multivariate logistic regression, the level of statistical significance was declared at p-value <= 0.05. Results: Among HDU admissions, 11% (16/142) developed AKI. Vasopressors were required in 2.1%, primarily noradrenaline (66.7%) and adrenaline (33.3%), while 1.4% required mechanical ventilation. Nephrotoxic drugs were administered to 30.3% of patients, mostly NSAIDs (76.7%). Blood transfusions were given to 26.1%, and surgical interventions were required in 3.5%. Multivariable analysis revealed that rural residence (AOR = 5.7, 95% CI: 1.23–28.29), pre-existing hypertensive disorders (AOR = 3.8, 95% CI: 2.19–16.01), and obstetric hemorrhage (AOR = 3.7, 95% CI: 1.99–13.66) were significant predictors of AKI. Conclusion: AKI affected more than one in ten obstetric women admitted to the HDU, with hypertensive disorders, hemorrhage, and rural residence as key risk factors. Early recognition, avoidance of nephrotoxic drugs, timely fluid resuscitation, and close monitoring are essential to reduce the burden of AKI in resource-limited obstetric care. Key words: Kidney injury, obstetric patients, obstetric, high dependency unit