Alterações da função renal em pacientes com síndrome HELLP: uma revisão integrativa

Abstract

The HELLP syndrome (hemolysis, elevated liver enzymes, low platelet count) is a hypertensive disorder during pregnancy or in the puerperium in which patients present with hemolysis, increased activity of liver enzymes and thrombocytopenia. Considered by many authors as a complication of preeclampsia, the syndrome characterizes pregnancy as high risk. The symptoms of HELLP syndrome are nonspecific and include visual, cerebral, epigastric pain and pulmonary edema, which is why it is difficult to make an accurate and early diagnosis. The problems arising from hypertensive disorders in pregnancy can affect various organs such as the kidneys, lungs and heart. Although there are assumptions about the causes for the development of the disease, the etiology still remains unknown. Therefore, the present study aimed to evaluate the information about changes in renal function in patients who were diagnosed with HELLP syndrome. For this, an integrative literature review was carried out with research in the SciELO, LILACS and PubMed databases, using the descriptors obtained from the Medical Subject Headings (MESH): “HELLP Syndrome”, “Kidney” and obtained from Descriptors in Health Sciences (DECS): “Síndrome HELLP”, “Renal” in the period from 2013 to 2023 in publications that addressed the subject studied. Initially, 168 articles were found that, after exclusions due to non-inclusion criteria, to repeated articles and out of topic based on the analysis of the title and abstract; 9 articles were selected for discussion of their results. The research highlighted that in retrospective studies, acute kidney injury (AKI) was the main complication of hypertensive disorders, including HELLP syndrome. This did not happen in only one study, but AKI was among the main complications, thus evidencing the need to prevent the disease by reducing risk factors and, in case of a positive diagnosis, that this occurs quickly in order to to initiate the appropriate treatments and procedures. Since there is a lack of complete understanding about the etiology and pathophysiology, there is a need for further studies on renal injury associated with HELLP syndrome.