Early acute kidney injury is associated with in-hospital adverse outcomes in critically ill burn patients: an observational study


 
 
 There are no studies in large series of burn patients on the relationship between acute kidney injury (AKI) and adverse outcomes using the KDIGO guidelines criteria.
 
 
 
 We retrospectively analyzed data from a cohort of burn patients admitted to the Intensive Care Unit (ICU) with the diagnosis of burn injury. The diagnosis of AKI over the first 7 days after injury was made according to the KDIGO guidelines criteria. The primary outcome was ICU mortality. We used estimative models using univariable and multivariable logistic regression analyses.
 
 
 
 960 patients were studied. AKI was diagnosed in 50.5% of all cases. In multivariable analysis, AKI was associated, as compared to patients without AKI, with ICU mortality (adjusted odds ratio [aOR] and 95% confidence interval 2.135 [1.384–3.293]) and secondary outcomes (kidney replacement therapy, aOR 4.030 [1.838–8.835]; infection, aOR 1.437 [1.107–1.866]; and hospital mortality, aOR 1.652 [1.139–2.697]). AKI Stage I was associated with a higher ICU (aOR 1.869 [1.183–2.954]) and hospital mortality (aOR 1.552 [1.050–2.296]), and infection (aOR 1.383 [1.049–1-823]). AKI meeting the UO criterion alone was not associated with increased mortality. Ignoring the UO criterion would have missed 50 (10.3%) cases with AKI.
 
 
 
 The KDIGO guidelines criteria are useful to diagnose AKI in burn patients. Even the mild form of AKI is independently associated with increased mortality. Considering the UO criterion is important to more accurately assess the incidence of AKI, but AKI meeting UO criterion alone is not associated with increased mortality.
