Acute Posttraumatic Renal Failure: A Multicenter Perspective

A Multi-Center Evaluation of Early Acute Kidney Injury in Critically Ill Trauma Patients

“…[21][22][23][24][25][26][27] Morris et al performed a retrospective study of 72,757 admissions to nine regional trauma centers over a five-year period and found only 78 patients (0.1%) developed AKI requiring renal replacement therapy (RRT). [25] While these data might suggest AKI in trauma is rare, it did not focus on trauma requiring ICU admission. More recently, Brandt et al conducted a single-center retrospective study of 1,033 ICU admissions for trauma and found AKI occurred in 23.8%.…”

“…[21] Emerging data suggest that the burden of AKI in trauma may be increasing; however, most studies to date are limited by small sample size, [23,24,26] single-center design, [21,26,28] focus on selected trauma populations, [22] or use of variable definitions for AKI, [21,25,27] or are potentially confounded by including late or delayed-onset of AKI that may not be attributable to trauma. [21,25,27] An evaluation of the epidemiology of AKI in trauma is important for health resource allocation, identification of high risk populations, development of preventative strategies, and for surveillance of long-term clinical consequences. Accordingly, we interrogated the Australian and New Zealand Intensive Care Society (ANZICS) Adult Patient Database (APD) to obtain information on the epidemiology of early AKI, defined as AKI evident within 24 hours of ICU admission, for all ICU admissions related to trauma from 57 Australian ICUs over a five-year period.…”

Predictors of Mortality in Acute Renal Failure in a Developing Country: A Prospective Study

“…There are studies addressing the issue of prognostic factors that determine the outcome in ARF, but these are generally confined to specific situations like ARF following aortic aneurysm surgery, [2] post-traumatic ARF, [3] and ARF in the critically ill patients. [4] Few studies have been done in a prospective manner in an unselected population.…”

Eventos vitais estressores e lesão renal aguda em centros de terapia semi-intensiva e intensiva

“…[1][2][3] Many conditions are associated with AKI, such as cardiocirculatory surgeries, polytraumatism, septicemia, use of contrast, bleeding, among others. [3][4][5][6] The high mortality rate of these pathologies, especially in ICU, brings out the need for attention for this disease. [1][2][3][4][5][6][7] Studies on chronic kidney diseases have shown the importance of ethnical, 8 environmental, 9,10 socioeconomical, [11][12][13][14][15] and psychic factors, modulating the disease, its complications and progonosis.…”

“…[3][4][5][6] The high mortality rate of these pathologies, especially in ICU, brings out the need for attention for this disease. [1][2][3][4][5][6][7] Studies on chronic kidney diseases have shown the importance of ethnical, 8 environmental, 9,10 socioeconomical, [11][12][13][14][15] and psychic factors, modulating the disease, its complications and progonosis. 16 Many investigations have demonstrated that chronic stress conditions are associated with allostatic overload, 17,18 that is, the attempt of the body to find stability through stressful change, thus leading to changes in cortisol and insulin levels, in the hypothalamo-hypophyseal axis (HPA), kinins, and other proinflammatory elements, among other homeostatic changes.…”