Acute kidney injury network classification system for evaluation of acute kidney injury in patients with severe traumatic brain injury

Abstract

Objective To evaluate the incidence,severity,risk tactors and impact to prognosis of acute kidney injury (AKI) in patients with severe traumatic brain injury (sTBI) by using acute kidney injury network (AKIN) classification system.Methods A retrospective analysis was carried out in 136 patients with sTBI hospitalized between January 2007 and May 2011.Demographic data,admission evaluation (whether with hernia or not on admission,systolic pressure and mean arterial blood pressure,serum creatinine and urea nitrogen,and blood glucose),outcome at 6 months post-injury and mortality were collected.Renal function was assessed using AKIN criteria.The patients were divided into two groups based on the presence or absence of AKI (non-AKI group and AKI group).According to the severity of AKI,AKI group was further classified as AKI grade 1 group,AKI grade 2 group and AKI grade 3 group.The differences among groups were analyzed.Results According to AKIN classification system,31 (23％) out of the 136 patients were diagnosed as being with AKI,including 21 cases (68％) in AKI grade 1 group and 10 cases (32％) in AKI grade 2 and 3 groups.The patients at older age and with lower Glasgow coma scale (GCS) on admission,higher levels of serum creatinine and blood urea nitrogen on admission were prone to AKI.As compared with TBI patients with normal renal function,TBI patients associated with AKI had higher mortality and worse outcome.Conclusions AKI is a common complication of patients with sTBI.AKIN classification system can early diagnose AKI in sTBI patients and may contribute to improvement of the outcome. Key words: Brain injuries; Renal insufficiency ; Prognosis