Post-traumatic acute renal failure: The epidemiological, clinical, etiological aspects and the predictive factors for the occurrence of post-traumatic AKI

Introduction The occurrence of acute kidney injury (AKI) in patients with multiple traumas is a serious complication, which can be fatal.The objective of our study was to precise the epidemiological, clinical, etiological aspects and the predictive factors for the occurrence of post-traumatic AKI. Description/Methods A cohort study has been conducted for 3 months including multiple-traumatic patients who have developed AKI hospitalised in the intensive care unit.AKI was defined according to KDIGO criteria. Results obtained or awaited Thirty-seven patients with multiple traumas were included. Among them, 9 developed an AKI. The average age was 38 years (18–75 years) and the sex ratio M/F was 8. At admission, 8 patients presented a neurological distress with an average Glasgow scale at 9 (5–15).Respiratory distress was observed into 7 patients with an average initial gas ratio of 226 (147–300). The mean blood pressure was 77.33% with use of catecholamines in 77.77% cases. AKI appeared on average of 2 days (1–7 days). There were 5 patients in stage 1 (KDIGO), 2 patients in stage 2 and 2 patients in stage 3. Oligoanuria was observed in 2 patients. One patient required extra-renal replacement therapy. An initial IGSII score>31.1 points was predictive of the occurrence of post-traumatic AKI (P=0.002), sensitivity 77.8%, specificity 75%. The etiology of AKI was pre-renal in 6 cases, tubular necrosis in 3 cases (2 with ischemic cause and 1 with toxic cause). A total resumption of renal function was observed in 7 patients. A residual renal failure was noted in 2 patients. Mortality was 33.33% due to multi-visceral failure. Conclusion AKI in multiple-traumatic patients is a frequent and serious complication. It is generally linked to kidney low perfusion secondary to trauma-related haemorrhage.