Hyperphosphatemia as a biomarker for early renal failure after trauma and development of the risk-for-renal-replacement-after-trauma (R3T) score

IF 2.3 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2026-03-01 Epub Date: 2025-12-23 DOI:10.1016/j.amjsurg.2025.116796

Ryan D. Rosen , Meredith Hazelrigg , Amanda B. Dooley-Romero , Mitchell Rits , Samantha L. Tarras , Heather Dolman

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引用次数: 0

Abstract

Background

Hyperphosphatemia occurs after trauma due to severe tissue injury. As the kidneys excrete phosphate, we investigate the relationship between hyperphosphatemia and renal failure after trauma, while developing a tool to predict the need for renal replacement therapy (RRT).

Methods

A retrospective study evaluated trauma admissions to the ICU. The primary outcome was RRT initiation within 14 days. Independent predictors of RRT were derived to create the Risk-for-Renal-Replacement-after-Trauma (R3T) Score. The R3T was validated with receiver-operating-characteristic (ROC) curves.

Results

1619 patients were included; 54 (3.3 %) required RRT. Elevated serum phosphate was associated with increased risk for RRT. Seven independent predictors were included in the R3T, yielding an area under the ROC curve of 0.947.

Conclusions

Hyperphosphatemia was associated with increased risk for RRT, suggesting phosphate levels are an inexpensive biomarker for renal failure after trauma. The R3T Score shows promise in identifying those at highest risk for RRT.

查看原文本刊更多论文

高磷血症作为创伤后早期肾衰竭的生物标志物和创伤后肾替代风险（R3T）评分的发展。

背景：高磷血症发生在严重组织损伤后。由于肾脏分泌磷酸盐，我们研究了创伤后高磷血症与肾功能衰竭之间的关系，同时开发了一种预测肾脏替代治疗（RRT）需求的工具。方法：回顾性研究评估创伤入院ICU。主要终点是在14天内启动RRT。导出RRT的独立预测因子以创建创伤后肾置换风险（R3T）评分。采用受试者工作特征（ROC）曲线对R3T进行验证。结果：共纳入1619例患者；54例（3.3%）需要RRT。血清磷酸盐升高与RRT风险增加相关。R3T中包含7个独立预测因子，ROC曲线下面积为0.947。结论：高磷血症与RRT风险增加相关，表明磷酸盐水平是创伤后肾衰竭的廉价生物标志物。R3T评分在识别RRT风险最高的人群方面显示出希望。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.