Early Acute Kidney Injury in Adult Burn Patients: Outcome and Risk Factors.

Abstract

The objective of this study was to investigate the characteristics and risk factors for early acute kidney injury (AKI) amongst adult patients with severe burns. KDIGO criteria was used to determine and classify the stage of AKI. Early AKI was defined if occurring within 3 days after burn. The results showed that of amongst 241 enrolled patients, early AKI developed in 25.3% of cases. Of them, AKI stage I was 60.7%, followed by stage II (26.2%) and stage III. Mortality rate of patients who developed early AKI was significantly higher than in the non-AKI group (54.1% vs. 15.6%; p = .001). Compared with the non early-AKI group, patients who developed early AKI were significantly older, suffered larger burn extent and deep burn area, and higher rate of inhalation injury (p <.005). In addition, prevalance of required mechanical ventilation, and concentrations of hematocrit and arterial blood lactate level on admission were significantly higher in the early AKI group (p <.001). Admission pH value, levels of protein and albumin were remarkably lower than in the group with early AKI (p <0.01). Multivariate analysis showed that deep burn area, arterial blood lactate level and mechanical ventilation on admission were independently associated with AKI. The incidence of early AKI increases along with number of independent risk factors. This was 19.7% with 1 risk factor, then it increased to 24.6% with 2 factors and up to 36.1% with 3 risk factors (p <.001).