Karan N, Patnaik R. Revisiting acute kidney injury outcomes in traumatic brain injury. World J Crit Care Med 2026; 15(1): 114998 [DOI: 10.5492/wjccm.v15.i1.114998]
Corresponding Author of This Article
Rohit Patnaik, DM, Department of Critical Care Medicine, Medeor 24x7 Hospital, Al Falah Street – Al Danah – Zone 1, Abu Dhabi 40330, United Arab Emirates. rohitpatnaik09@gmail.com
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Critical Care Medicine
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Letter to the Editor
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Mar 9, 2026 (publication date) through Mar 6, 2026
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World Journal of Critical Care Medicine
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2220-3141
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Karan N, Patnaik R. Revisiting acute kidney injury outcomes in traumatic brain injury. World J Crit Care Med 2026; 15(1): 114998 [DOI: 10.5492/wjccm.v15.i1.114998]
World J Crit Care Med. Mar 9, 2026; 15(1): 114998 Published online Mar 9, 2026. doi: 10.5492/wjccm.v15.i1.114998
Revisiting acute kidney injury outcomes in traumatic brain injury
Nupur Karan, Rohit Patnaik
Nupur Karan, Department of Anaesthesiology, All India Institute of Medical Sciences, Raipur 492099, Chhattisgarh, India
Rohit Patnaik, Department of Critical Care Medicine, Medeor 24x7 Hospital, Abu Dhabi 40330, United Arab Emirates
Author contributions: Karan N wrote the original draft; Karan N and Patnaik R contributed to the conceptualization, writing, reviewing, and editing, participated in drafting the manuscript; all authors have read and approved the final version of the manuscript.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Corresponding author: Rohit Patnaik, DM, Department of Critical Care Medicine, Medeor 24x7 Hospital, Al Falah Street – Al Danah – Zone 1, Abu Dhabi 40330, United Arab Emirates. rohitpatnaik09@gmail.com
Received: October 9, 2025 Revised: November 21, 2025 Accepted: January 9, 2026 Published online: March 9, 2026 Processing time: 143 Days and 17.5 Hours
Abstract
Acute kidney injury in traumatic brain injury is a major concern, affecting up to 10% of the patients in intensive care unit due to multifaceted mechanisms, including hemorrhagic shock, rhabdomyolysis, and brain-kidney cross-talk, compounded by hyperosmolar therapies. A significant challenge is that serum creatinine is considered a late and nonspecific marker, often missing the critical early insult phase. Future strategies for early prediction and prevention must focus on emerging factors, such as preventing hyperchloremia and utilizing novel biomarkers, such as neutrophil gelatinase-associated lipocalin and kidney injury molecule 1, which detect subclinical injury and predict the need for renal replacement therapy. Composite risk stratification tools (e.g., renal angina index) are vital for personalized management. Although over 90% of patients recover renal function, prevention of collateral damage to the kidney must be recognized as a critical priority in traumatic brain injury care.
Core Tip: Trauma-related acute kidney injury is a critical concern in traumatic brain injury care, affecting up to 10% of intensive care unit patients. Since creatinine is a late marker, early prediction is vital. Strategies must focus on preventing hyperchloremia using novel biomarkers (e.g., neutrophil gelatinase-associated lipocalin/kidney injury molecule 1) and risk stratification tools to detect subclinical injury and prevent collateral kidney damage.
