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Title Acute Kidney Injury in Severe Burns – A Single Centre Experience in a Tertiary Centre in Singapore |
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Type Poster Presentation |
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Theme 18th Asian Colloquium in Nephrology (18th ACN 2019) |
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Topic Acute Kidney Injury |
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Main Author Riece Koniman1 |
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Presenting Author Riece Koniman1 |
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Co-Author Han Kim Tan 1 Su Hooi Teo1 Chee Wooi Tan Hui Hua Li2 Marjorie Foo1 Bien Keem Tan3 Si Jack Chong3 Manish Kaushik1 |
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Department / Institution / Country Renal Medicine / Singapore General Hospital / Singapore1 Division of Medicine / Singapore General Hospital / Singapore2 Plastic, Reconstructive & Aesthetic Surgery / Singapore General Hospital / Singapore3 |
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Abstract Content: Introduction, Method, Result, Conclusion Introduction Acute kidney injury (AKI) is a frequent complication of severe burn injury (SBI) and is associated with a high mortality rate of up to 80%. We aimed to establish the incidence, mortality rate, and factors related to mortality in severe burn adult patients with AKI requiring renal replacement therapy (RRT) in Singapore.
Methods We conducted a retrospective cohort study of SBI patients who were admitted to the Burns Intensive Care Unit at the Singapore General Hospital from January 2008 to December 2016. We compared demographics, clinical and laboratory data of patients with AKI requiring RRT who survived with those who did not survive.AKI was defined based on the 2012 Kidney Disease: Improving Global Outcomes classification.
Results Data of 201 patients were studied. The incidence of AKI requiring RRT in SBI was 21.9% and their mortality rate was 50%. The non-survivors had significantly higher median TBSA (67.5% versus 48.5%), earlier onset of AKI (0 versus 0.5 day after admission), earlier initiation of RRT (2 versus 8 days after admission), lower rate of renal recovery (9.1% versus 77.3%), higher rateof adult respiratory distress syndrome (63.6% versus 18.2%) and shock requiring vasopressors (95.5% versus 59.1%) compared to the survivors.
Conclusions The incidence of AKI requiring RRT in the Singapore study cohort was high, but their mortality rate was relatively lower compared to other study cohorts. Severity of AKI and requirement for RRT were associated with poor prognosis. Further prospective studies are required to examine the risk factors for mortality in SBI-AKI and establish cause-and-effect relationship. |