Fig 2 - available via license: Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
Content may be subject to copyright.
Source publication
Background
Polytrauma can lead to multi-organ dysfunction in addition to the local injuries. Acute kidney injury (AKI) is one of the most common causes and contributors to the high morbidity and mortality. Prevalence of acute kidney injury in trauma patients is as reported to be as high as 40.3%. Early detection and management leads to better outco...
Context in source publication
Citations
... Kidneys are most vulnerable to dysfunction in polytrauma patients because of various trauma-related pathological factors [4,5]. The reported incidence of acute kidney injury (AKI) in polytrauma victims is 25%-40% [4][5][6]. Patients with old age, with comorbid conditions like hypertension, diabetes mellitus, ischemic heart disease, and with underlying renal dysfunction are highly vulnerable to developing AKI after polytrauma [7]. The usual causes of AKI in polytrauma patients are hemorrhagic/ hypovolemic shock, rhabdomyolysis, abdominal compartment syndrome (ACS), use of contrast media for various radiological investigations, hypotension associated with surgery/anesthesia and sedation, use of blood and blood product, use of nephrotoxic drugs, and direct injury to kidney, ureter, and bladder [8]. ...
... Acute reduction of renal function is defined as AKI [14]. AKI after polytrauma is a common kidney-related complication; the reported incidence of AKI after polytrauma is 25%-40% [4][5][6]. In our study, the incidence of AKI after polytrauma is found to be 30.5%. ...
... The eventuality of rhabdomyolysis and ACS after polytrauma is also correlated with high ISS [24][25][26]. Thus, in the present or earlier studies [4][5][6][7][8], whatever shock, the need for massive transfusion, rhabdomyolysis, and ACS observed are a mere reflection of severe polytrauma as evident from high ISS in the AKI group. ...
Background:
Polytrauma from road accidents is a common cause of hospital admissions and deaths, frequently leading to acute kidney injury (AKI) and impacting patient outcomes.
Methods:
This retrospective, single-center study included polytrauma victims with an Injury Severity Score (ISS) >25 at a tertiary healthcare center in Dubai.
Results:
The incidence of AKI in polytrauma victims is 30.5%, associated with higher Carlson comorbidity index (P=0.021) and ISS (P=0.001). Logistic regression shows a significant relationship between ISS and AKI (odds ratio [OR], 1.191; 95% confidence interval [CI], 1.150-1.233; P<0.05). The main causes of trauma-induced AKI are hemorrhagic shock (P=0.001), need for massive transfusion (P<0.001), rhabdomyolysis (P=0.001), and abdominal compartment syndrome (ACS; P<0.001). On multivariate logistic regression AKI can be predicated by higher ISS (OR, 1.08; 95% CI, 1.00-1.17; P=0.05) and low mixed venous oxygen saturation (OR, 1.13; 95% CI, 1.05-1.22; P<0.001). The development of AKI after polytrauma increases length of stay (LOS)-hospital (P=0.006), LOS-intensive care unit (ICU; P=0.003), need for mechanical ventilation (MV) (P<0.001), ventilator days (P=0.001), and mortality (P<0.001).
Conclusions:
After polytrauma, the occurrence of AKI leads to prolonged hospital and ICU stays, increased need for mechanical ventilation, more ventilator days, and a higher mortality rate. AKI could significantly impact their prognosis.
... ere are no reliable statistics on the incidence of AKI in SSA [5][6][7][8]. AKI can be community-acquired, resulting from poisoning, envenomation or infection prior to hospital admission, or hospital-acquired, occurring following hospital management [9][10][11]. Community-acquired AKI tends to occur in low-income countries and in young people with few comorbidities, whereas hospital-acquired AKI tends to occur in high-income countries and in older people (45-80 years) often with multiple comorbidities [12]. ...
... In this literature review, we focused on the epidemiology of AKI in adult inpatients. Many previous studies have attempted to provide estimates of the incidence of AKI, but it is important to note that there is significant variability between studies due to the type of study, the definition of AKI, the location of patient recruitment and the length of the observation period for AKI occurrence [10]. Despite the use of new classifications, the epidemiology of AKI remains difficult to define. ...
Acute kidney injury (AKI) is a complex condition that can occur in both community and hospital settings and has many aetiologies. These aetiologies may be infectious, toxic, surgical, or related to the different management methods. Although it is a major public health problem worldwide, it must be emphasised that both its incidence and mortality rate appear to be very high in sub-Saharan African (SSA) countries compared to developed countries. The profile of AKI is very different from that of more developed countries. There are no reliable statistics on the incidence of AKI in SSA. Infections (malaria, HIV, diarrhoeal, and other diseases), nephrotoxins, and obstetric and surgical complications are the main aetiologies in Africa. The management of AKI is costly and associated with high rates of prolonged hospitalisation and in-hospital mortality.
Before considering the kidney trauma grade itself, it is important to remember some vital principles.
Cedera ginjal akut atau Acute Kidney Injury (AKI) adalah salah satu sindrom klinis yang menyebabkan risiko mortalitas dan morbiditas yang tinggi. Deteksi dini AKI sangat diperlukan untuk mencegah kerusakan ginjal permanen dan memperlambat perkembangan AKI. Kidney Injury Molecule-1 (KIM-1) adalah biomarker yang sensitif, spesifik dan cepat dalam deteksi dini AKI. KIM-1 akan diekspresikan berlebih pada sel epitel tubulus proksimal setelah adanya cedera pada ginjal. KIM-1 dapat menggambarkan disfungsi ginjal melalui cairan tubuh, seperti plasma dan urin. Kajian pustaka ini membahas karakteristik, peran dan metode pengukuran KIM-1 sebagai biomarker untuk deteksi dini AKI. Kajian dilakukan terhadap 51 artikel yang didapat dari basis data PubMed dengan kata kunci “Kidney Injury Molecule-1”, “KIM-1 Biomarker”, “KIM-1 assay”, “Acute Kidney Injury” dan “KIM-1 kidney injury biomarker”. KIM-1 adalah glikoprotein transmembran tipe I dengan berat molekul ~104 kDa yang mengalami peningkatan konsentrasi di membran apikal sel epitel tubulus proksimal dan berperan dalam patogenesis cedera sel tubulus ginjal. KIM-1 memiliki sensitivitas dan spesifisitas yang baik dengan nilai AUC-ROC >0,5. Metode pengukuran yang paling banyak digunakan adalah ELISA dan sampel yang paling banyak digunakan adalah urin karena peningkatannya lebih jelas dibanding dengan plasma. KIM-1 urin yang diukur menggunakan metode ELISA memiliki potensi untuk dikembangkan dan digunakan sebagai parameter diagnosis dini AKI di masa mendatang
