+ Site Statistics
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Acute kidney injury following severe trauma: Risk factors and long-term outcome

Acute kidney injury following severe trauma: Risk factors and long-term outcome

Journal of Trauma and Acute Care Surgery 79(3): 407-412

The trauma patient sustains numerous potentially harmful insults that may contribute to a notable risk of acute kidney injury (AKI). The aim of this study was to investigate the incidence of and to identify risk factors for AKI in severely injured trauma patients admitted to the intensive care unit (ICU). The patients were followed up for 1 year with respect to survival and end-stage renal disease. Trauma patients admitted to the ICU for more than 24 hours at a Level I trauma center were included. The outcome measure was AKI diagnosed Days 2 to 7 of ICU treatment. Regression analysis was performed to identify factors associated with AKI development. A quarter of the patients (103 of 413) developed AKI within the first week of ICU admission. AKI was associated with increased 30-day (17.5% vs. 5.8%) and 1-year (26.2% vs. 7.1%) mortality. Risk factors for AKI were male sex, age, nondiabetic comorbidity, diabetes mellitus, Injury Severity Score (ISS) greater than 40, massive transfusion, and volume loading with hydroxyethyl starch (HES) within the first 24 hours. Unexpectedly, sepsis before AKI onset, admission hypotension, and extensive contrast loading (>150 mL) were not associated with AKI development. None of the surviving AKI patients had developed end-stage renal disease 1 year after injury. AKI in ICU-admitted trauma patients is a common complication with substantial mortality. Diabetes, male sex, and severe injury were strong risk factors, but age, nondiabetic comorbidity, massive transfusion, and resuscitation with HES were also associated with postinjury AKI. Based on the results of the current study, volume resuscitation with HES cannot be recommended in trauma patients. Prognostic study, level III; therapeutic study, level IV.

(PDF emailed within 0-6 h: $19.90)

Accession: 057133374

Download citation: RISBibTeXText

PMID: 26307873

DOI: 10.1097/TA.0000000000000727

Related references

Risk factors and outcome of acute kidney injury in elderly trauma patients. American Journal of Surgery 2019, 2019

Renal outcome in long-term survivors from severe acute kidney injury in childhood. Pediatric Nephrology 27(1): 151-2; Author Reply 153, 2012

Long-term outcome of severe acute kidney injury survivors followed by nephrologists in a developing country. Nephrology 21(4): 327-334, 2017

Histopathology and Long-Term Outcome of Kidneys Transplanted From Donors With Severe Acute Kidney Injury. Progress in Transplantation 29(1): 36-42, 2019

Acute kidney injury in survivors of surgery for severe traumatic brain injury: Incidence, risk factors, and outcome from a tertiary neuroscience center in India. British Journal of Neurosurgery 29(4): 544-548, 2016

Repeated Contrast Administration Is Associated With Low Risk of Postcontrast Acute Kidney Injury and Long-Term Complications in Patients With Severe Chronic Kidney Disease. American Journal of Transplantation 16(3): 897-907, 2016

Short and long-term outcome of patients with severe acute kidney injury requiring renal replacement therapy. Qjm 105(1): 33-39, 2012

Long-Term Risk of Progressive Chronic Kidney Disease in Patients with Severe Acute Kidney Injury Requiring Dialysis after Coronary Artery Bypass Surgery. Cardiorenal Medicine 5(3): 157-163, 2015

Risk Factors for Long-Term Mortality and Progressive Chronic Kidney Disease Associated With Acute Kidney Injury After Cardiac Surgery. Medicine 94(45): E2025, 2016

Acute kidney injury after non-cardiovascular surgery: risk factors and impact on development of chronic kidney disease and long-term mortality. Current Medical Research and Opinion 34(10): 1829-1837, 2018

Acute and chronic kidney disease in elderly patients with hip fracture: prevalence, risk factors and outcome with development and validation of a risk prediction model for acute kidney injury. Bmc Nephrology 18(1): 20, 2017

Risk of Acute Kidney Injury and Long-Term Outcome in Patients With Acetaminophen Intoxication: A Nationwide Population-Based Retrospective Cohort Study. Medicine 94(46): E2040, 2016

Acute kidney injury following coronary angiography: a nationwide study of incidence, risk factors and long-term outcomes. Journal of Nephrology 31(5): 721-730, 2018

Long-Term Outcomes and Associated Risk Factors of Post-Hospitalization Dialysis-Dependent Acute Kidney Injury Patients. Nephron 137(2): 105-112, 2017

Understanding the Risk Factors and Long-Term Consequences of Cisplatin-Associated Acute Kidney Injury: An Observational Cohort Study. Plos One 10(11): E0142225, 2016