C. E. Stegall1, A. J. Stewart1, J. P. Winkler1 1University Of Alabama at Birmingham, Center For Injury Science, Birmingham, Alabama, USA
Introduction: Patients sustaining burn injuries are at an increased risk for the development of acute kidney injury (AKI). AKI is associated with increased morbidity and mortality making early recognition of impaired kidney function imperative. The use of creatinine and urine output as markers of renal function becomes less reliable as inflammatory mediators lead to intercompartmental fluid shifts and large-volume resuscitative measures progress. The aim of this study was to evaluate baseline creatinine at arrival and early changes in creatinine values for correlation with the development of AKI.
Method: A total of 108 patients presenting with burn injuries between August 2021 and July 2022 were identified from the Trauma Registry. Forty-eight patients were excluded for reasons including total burn surface area (TBSA) of less than 20%, inhalation or electrical injury only, or incomplete charts. Charts were reviewed for total burn surface area, serum creatinine values, and the development of AKI as defined by the Kidney Disease Improving Global Outcomes criteria.
Results: Patients who developed an AKI during hospitalization presented with a mean initial creatinine of 1.14 ± 0.48 compared to 0.92 ± 0.15 in patients who did not develop an AKI. An average increase of 0.12 mg/dL in the first six hours of resuscitation was demonstrated in the AKI group, while no change was seen in the non-AKI group. These findings were statistically significant (p-value 0.0080).
Conclusion: Burn injury patients presenting with an initial serum creatinine ≥ 1.0 mg/dL or an increase ≥ 10% of baseline creatinine within the first six hours of resuscitation are at an increased risk for the development of an acute kidney injury.
