Acute kidney injury in severely injured patients admitted to the intensive care unit

Abstract

Background Our objective was to identify possible associations between clinical and laboratory variables and the risk of developing acute kidney injury (AKI) in severely injured patients admitted to the intensive care unit (ICU) for whom creatine kinase (CK) levels were available. Methods For this retrospective observational study, we analyzed adult trauma patients admitted to the ICU from 2011 to 2015 at Fundación Valle del Lili (FVL) University Hospital. Our primary outcome was the incidence of AKI. Multivariate regression analysis was used to assess risk factors for this outcome. Results A total of 315 patients were included. The trauma mechanisms were blunt (n = 130), penetrating (n = 66) and blast (n = 44) trauma. The median (interquartile range, IQR) of injury severity score (ISS) was 21 (16–29). AKI developed in 75 patients (23.8%). Multivariate regression analysis revealed that the thoracic abbreviated injury scale (AIS) value (median (IQR) in the AKI group: 3 (0–4)), Acute Physiology and Chronic Health Evaluation (APACHE II) score (median (IQR) in the AKI group: 18 (10–27)), CK greater than 5000 U/L, lactic acid concentration at admission, and dobutamine administration were independently associated with AKI. Conclusion We found that age, APACHE II score, thoracic trauma, lactic acidosis, and dobutamine administration were independently associated with AKI. Trauma surgeons need to be aware of the increased odds of AKI if one of these factors is identified during the evaluation and treatment of injured patients.

The Effects of serum glucose level on the association of between serum lactate level and acute kidney injury among critical patient with acute ischemic stroke

“…Studies have demonstrated that the mortality rate among AIS patients with AKI is three times higher than that among those without AKI (16). In addition, for intensive care patients, occurrence of AKI will increase their mortality (17). Therefore, it is particularly important to screen for AKI-related risk factors among critical patient with AIS.…”

Measurement of Serum Levels of 5 Amino Acids and Dimethylamine Using Liquid Chromatography-Tandem Mass Spectrometry in Patients without Septic Associated Acute Kidney Injury and with Septic Associated Acute Kidney Injury Requiring Continuous Renal Replacement Therapy

“…Acute kidney injury (AKI) is one of the most common organ failures in patients hospitalized in intensive care units (ICUs) [ 1 ]. The incidence varies from 5% to 50% depending on the literature and is associated with a mortality rate of up to 50% [ 2 – 4 ].…”