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Trauma induced acute kidney injury
Zane B Perkins1, Gabriella Captur2,3, Ruth Bird2
1Centre for Trauma Sciences, Queen Mary, University of London, London, United Kingdom.
Plos One
|January 26, 2019
Summary
Acute kidney injury (AKI) affects 12.6% of trauma patients and significantly increases mortality risk. Identifying risk factors like age and injury severity is crucial for early intervention in trauma care.
Area of Science:
- Trauma care and critical illness research.
- Nephrology and renal medicine.
- Epidemiology of injury and complications.
Background:
- Injured patients face a high risk of acute kidney injury (AKI), a condition linked to increased illness and death.
- Understanding AKI's incidence, timing, and severity in trauma is vital.
Purpose of the Study:
- To determine the incidence, timing, and severity of AKI in a large trauma patient cohort.
- To identify independent risk factors contributing to AKI development post-trauma.
- To analyze the impact of AKI on mortality outcomes in injured individuals.
Main Methods:
- A prospective observational study was conducted on adult trauma patients admitted to a UK Major Trauma Centre.
- Acute kidney injury (AKI) diagnosis followed the Kidney Disease Improving Global Outcomes (KDIGO) criteria.
- Multivariable logistic regression and Cox proportional hazard models were employed to identify AKI and mortality predictors.
Main Results:
- 12.6% of 1410 trauma patients developed AKI.
- Independent risk factors for AKI included age, injury severity score (ISS), low systolic blood pressure, elevated lactate, higher serum creatinine, blood transfusions, and nephrotoxic therapy.
- AKI patients exhibited significantly higher mortality (26.4%) compared to those without AKI (10.4%).
Conclusions:
- Acute kidney injury (AKI) is a common and serious complication following trauma, associated with longer hospital stays and increased mortality.
- AKI is an independent predictor of mortality in trauma patients, even after accounting for other prognostic factors.
- Further research is essential to develop strategies for early AKI risk identification and renal function preservation in trauma resuscitation.
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