Wcn24-2050 Establishing the Prevalence of Acute Kidney Injury in a High-Risk Obstetric Cohort in a Tertiary Maternity Unit in Freetown, Sierra Leone

Haemorrhage, hypertension and sepsis cause 75% of maternal deaths in Sierra Leone, and globally, and commonly lead to Acute Kidney Injury, which is associated with high rates of maternal and fetal morbidity and mortality (6 to 52%). Most deaths and serious morbidity are preventable with early detection, enabling targeted management. However, challenges in laboratory infrastructure in low and middle income settings often leads to late or missed pregnancy AKI diagnoses. In a large prospective observational study in South Africa our group found that 15% (237/1547) of pregnant women admitted with hypertensive disorders had AKI, relative risk of death was 6.2% (95% CI 2.2-17) and 50% had persistent abnormal renal function, which is associated with development of CKD, cardiovascular disease and four fold greater risk of pre-eclampsia in future pregnancies.