Extensive burn is not only a skin injury but also a serious systemic illness often accompanied by various complications. Acute renal failure (ARF) is one of the major complications of burns, carrying an extremely high mortality rate (1). Although ARF is not commonly encountered in burned patients, this complication merits a special attention in that its outcome is generally very poor and varies depending on the severity and adequacy management of the burn injury. The quoted incidence of renal failure in burned patients varies widely between 0.5 and 30% and its mortality is as high as between 73 and 100%. The incidence and mortality rate of ARF in burned patients depend on the severity of the burns and on the criteria of renal failure such as free water clearance (greater than -0.5 mL/min), blood urea nitrogen (above 50 mg/dL) and serum creatinine level (above 2.0 mg/ dL) (2). These criteria have been used to assess the incidence and as an index in treating ARF in burned patients (3). Increased urinary excretion of protein is one of the most common and easily detected signs of renal pathology. Renal abnormalities may occur both in the quantity and in the composition of urinary proteins (4). Renal pathologies in burns are characterized by the development of extensive inflammation inducing an intensive acute phase response in the kidney. Urinary malondialdehyde (MDA) is a gross indicator of renal lipid peroxidation (5), and has been shown to increase after burns (6). The present study was aimed to estimate the degree of burn-induced renal damage and the recovery and to determine the treatment response in 12 patients with second-or third-degree burns admitted to the burn center at the Hallym University Hankang Medical Center within 12 hr of insult onset.
MATERIALS AND METHODS
PatientsWith approvals by the Ethics Committee of the Hallym University Hankang Medical Center and informed consents, 12 patients were selected among flame-burned patients admitted to the burn center at the Hallym University Hankang Medical Center within 12 hr of their injury. The subjects consisted of 10 males and 2 females with an age range from 23 to 65 yr (mean±SD, 37.7±13.6 yr) without chronic illnesses such as hypertension and diabetes mellitus. They had second-or third-degree flame burns covering 20 to 40%
Urinary N-acetyl--D-glucosaminidase and Malondialdehyde as a Markers of Renal Damage in Burned PatientsThis study was aimed to evaluate renal dysfunction during three weeks after the burn injuries in 12 patients admitted to the Hallym University Hankang Medical Center with flame burn injuries (total body surface area, 20-40%). Parameters assessed included 24-hr urine volume, blood urea nitrogen, serum creatinine, creatinine clearance, total urinary protein, urinary microalbumin, 24-hr urinary Nacetyl--D-glucosaminidase (NAG) activity, and urinary malondialdehyde (MDA). Statistical analysis was performed using repeated measures ANOVA test. The 24-hr urine volume, creatinine clearance, and urinary protein significantly increased on day ...