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Abstract: FR-PO062

AKI in Renal Trauma Patients

Session Information

  • AKI: Clinical Outcomes, Trials
    November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Chavez, Jonathan, Hospital Civil de Guadalajara, Guadalajara, Mexico
  • Ibarra-Estrada, Miguel A., Hospital Civil Fray Antonio Alcalde, Guadalajara, Mexico
  • Moreno, Rodolfo Alejandro, Hospital Civil de Guadalajara, Guadalajara, Mexico
  • Garcia-Garcia, Guillermo, Hospital Civil de Guadalajara, University of Guadalajara, Zapopan, Mexico
  • Valdivia cerda, Veronica, Hospital Civil de Guadalajara, La Barca, Mexico
  • Cervantes, Cynthia G., Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Mexico
  • Velarde, Enrique, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Mexico
Background

Kidney is the most commonly injured organ of the genitourinary system during trauma; little is known about the relationship that this event has with the incidence of acute kidney injury (AKI). In this cohort we describe the associated risk factors for the development of AKI in patients with renal trauma (RT).

Methods

In a prospective cohort, we analyzed patients with RT during 2015 to 2019 at the Hospital Civil de Guadalajara. We describe their demographic, clinical characteristics and risk factors for development of AKI with univariate and multivariate analysis.

Results

During the study period 65 patients were analyzed, sixty (92.3%) were men, mechanism of trauma was firearm in 26 (40%), transfusion was indicated in 18 (25%), and 46 (70%) required emergent surgery, nephrology was consulted in 12 (18%) cases. AKI was present in 39 (60%) patients. Creatinine and urea at hospital admission was highest in AKI group (1.56 ± 0.91mg/dL vs. 0.85 ± 0.24mg/dL, p = <0.001 and 56 ± 41mmol/L vs 34 ± 20mmol/L, p = 0.005; respectively). Nephrectomy was not different between those with 14 (35.9%) and without AKI 5 (19.2) (p=0.15), left kidney is the most affected (57%), Intestine and liver were the most common organs affected (37, 32%, respectively), there were only 4 deads, all in AKI group. RT was considered high-grade (4-5) in 37 (56.9%), which has a significant association (p = 0.04) with the incidence of AKI in the univariate analysis, but this association was lost in the multivariate analysis. We built a model for prediction of AKI with the most relevant variables: firearm injury, shock, emergent surgery, high grade RT, and liver injury (p= 0.02, AUC 0.74).

Conclusion

RT occurs mainly in young men, 60% of cases are complicated with AKI, the most significant risk factor is high grade RT. It is necessary to confirm this association in other populations and larger sample sizes.