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Related Experiment Videos

Acute posttraumatic renal failure: a multicenter perspective.

J A Morris1, P Mucha, S E Ross

  • 1Department of Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee.

The Journal of Trauma
|December 11, 1991
PubMed
Summary
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Acute renal failure (ARF) after trauma is rare but deadly. This study found ARF is uncommon in trauma patients, with a high mortality rate, especially for those with pre-existing conditions.

Area of Science:

  • Nephrology
  • Trauma Surgery
  • Critical Care Medicine

Background:

  • Acute renal failure (ARF) following trauma is a rare complication.
  • Historically, ARF has been associated with a high mortality rate.
  • Understanding the incidence, causes, and outcomes of posttraumatic ARF is crucial.

Purpose of the Study:

  • To investigate the incidence, clinical characteristics, and outcomes of acute renal failure requiring hemodialysis in trauma patients.
  • To identify risk factors and patterns of ARF development post-trauma.

Main Methods:

  • Retrospective review of 72,757 trauma admissions across nine regional trauma centers over five years.
  • Analysis of demographic, clinical, and outcome data for 78 patients who developed ARF requiring hemodialysis.

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  • Categorization of patients into early (less than 6 days post-injury) and late ARF groups.

    • Main Results:

    • The incidence of ARF requiring hemodialysis was 0.098% (107 per 100,000 trauma admissions).
    • Mortality rate was high at 57%, with a 70% increase in mortality for patients with pre-existing conditions.
    • Late ARF (two-thirds of cases) was predominantly secondary to multiple organ failure; early ARF (one-third) may relate to resuscitation issues.

    Conclusions:

    • Posttraumatic renal failure requiring hemodialysis is rare but carries a significant mortality risk.
    • Late-onset ARF is more common and often linked to multiple organ failure, while early ARF may stem from resuscitation inadequacy.
    • Effective management strategies for trauma patients at risk of ARF are needed to improve outcomes.