Abstract: PO0224
Evaluation of Chosen Biochemical Parameters in Diagnosis of AKI in Course of Burn Disease
Session Information
- AKI: Epidemiology, Risk Factors, and Prevention
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 101 AKI: Epidemiology, Risk Factors, and Prevention
Authors
- Klimm, Wojciech, Wojskowy Instytut Mediczny, Warszawa, Mazowieckie, Poland
- Szamotulska, Katarzyna, Instytut Matki i Dziecka, Warszawa, Poland
- Wozniak-Kosek, Agnieszka, Wojskowy Instytut Mediczny, Warszawa, Mazowieckie, Poland
- Niemczyk, Stanislaw, Wojskowy Instytut Mediczny, Warszawa, Mazowieckie, Poland
Background
Burn disease after severe thermal injury often causes multi-organ damage, included AKI. Diagnosis of AKI based on standard renal biomarkers seems to be not optimum, because of its too late beginning. The aim of the study is evaluation of non-renal biochemical parameters as early prognostic factors of AKI in this group of patiens (pts).
Methods
33 adult pts; 11(33,3%) females, 33(66,7%) males; were hospitalised after severe burn injury. Mean age was 48,3(±18,8) years. None of the pts presented symptoms of chronic kidney disease. Biochemical parameters - platelets count (PLT); serum concentration of albumin (ALB), sodium (Na), potassium (K), urea (U), creatinine (Cr); glomerular filtration ratio (GFR), serum activity of asparagine transaminase (AST) and creatine phosphokinase (CK); blood gas tests and urine sodium excretion - were measured at each patient once daily till 7thday. The results were presented as a mean value with standard deviation or median with interquartile range. AKI criteria were based on RIFLE/AKIN scale. Relationship between parameters and AKI risk were analysed with chi-square test and presented as relative risk (RR) with 95% confidence level, p-value significant level was <0,5.
Results
Biochemical symptoms of AKI were confirmed in 15 (60,6%) pts. AKI developed at the beginning of hospitalisation, on the1st day – 10 (30,3%) pts and 2rd day – 4 (12,1%) pts. Non-normative levels of biomarkers were reported in the same time: low PLT count - average 91,6(±42,7) x10^9/l in 5 (15%) pts; low ALB concentration – avg. 2,4(±0,7) g/dl in 32 (97%) pts; high K concentration – avg. 6,1(±0,7) mmol/l in 14 (42,4%) pts; high activity of AST – avg. 73(40,5÷141,5) U/l in 21(63,6%) pts and CK – avg. 429,0(242,0÷4720,0) U/l in 21 (63,6%) pts and metabolic acidosis with low pH - avg. 7,22(±0,08) in 19 (57,6)%, pts. The significant relationship between parameters and the risk of AKI was confirmed: high activity of CK (RR 2,86; p=0,047) and AST (RR 2,73; p=0,034), and low concentration of ALB (RR 2,63; p=0,012).
Conclusion
AKI is a frequent and important problem in burned patients, occurred in the first days after injury as a part of multi-organ dysfunction. Non-renal biochemical parameters as serum concentration of ALB, activity of CK and AST can be useful early biomarkers of AKI after massive burn injury.