Application of selected biochemical parameters in prediction of acute kidney injury risk at the early stage of burn disease
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Wojskowy Instytut Medyczny - Państwowy Instytut Badawczy, Klinika Chorób Wewnętrznych, Nefrologii i Dializoterapii, Polska
Zakład Epidemiologii i Biostatystyki, Instytut Matki i Dziecka, Polska
Wojskowy Instytut Medyczny - Państwowy Instytut Badawczy, Oddział Kliniczny Chirurgii Plastycznej, Rekonstrukcyjnej i Leczenia Oparzeń, Polska
Wojskowy Instytut Medyczny - Państwowy Instytut Badawczy, Zakład Diagnostyki Laboratoryjnej, Polska
Submission date: 2022-09-27
Final revision date: 2022-10-30
Acceptance date: 2022-11-02
Publication date: 2023-06-30
Corresponding author
Wojciech Klimm   

Wojskowy Instytut Medyczny – Państwowy Instytut Badawczy, Klinika Chorób Wewnętrznych, Nefrologii i Dializoterapii, Warszawa
LW 2023;101(2):99-110
Introduction and objective: Acute kidney injury (AKI) is a common, severe complication of burn disease, developing in the first days after a massive thermal injury and worsening the prognosis of patients. Early diagnosis of AKI plays a crucial role in improving health of patients and therapeutic results. Detection of AKI based on the standard parameters of renal function is insufficient due to too late changes in their values. The aim of the study is to evaluate the relationship between the selected non-renal biochemical parameters and the risk of AKI in this group of patients. Material and methods: The prospective study involved a group of 33 adult patients (22 men, 11 women) hospitalized after massive burns. The patients were intensively monitored for the first 7 days after the injury, daily assessing the parameters of renal function. The selected parameters were also measured: platelet count (PLT), sodium (Na), potassium (K), albumin (ALB), aspartate aminotransferase (AST), creatine kinase (CK), arterial blood pH, arterial blood bicarbonate (HCO3-), 24-hour urinary sodium excretion (24hUNa) and fractional excretion of sodium (FENa). Results: AKI was diagnosed in 15 (45.5%) patients. Statistical differences in the obtained average values of selected parameters between the AKI and non-AKI groups were confirmed. A significant univariate relationship was found between CK, AST and ALB in the blood serum and an increased risk of developing AKI in the following days. However, after adjustment for The Abbreviated Burn Severity Index score, only CK remained significant. Conclusions: The potential clinical benefit of monitoring AST and ALB in blood serum and especially CK was confirmed. The other routine parameters did not seem to be related to the risk of AKI and require further analysis.
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