Huang ZY, Liu Y, Huang HF, Huang SH, Wang JX, Tian JF, Zeng WX, Lv RG, Jiang S, Gao JL, Gao Y, Yu XX. Acute kidney injury in traumatic brain injury intensive care unit patients. World J Clin Cases 2022; 10(9): 2751-2763 [PMID: 35434091 DOI: 10.12998/wjcc.v10.i9.2751]
Corresponding Author of This Article
Xia-Xia Yu, PhD, Assistant Professor, School of Biomedical Engineering, Health Science Center, Shenzhen University, No. 1066 Xueyuan Avenue, Nanshan District, Shenzhen 518037, Guangdong Province, China. xiaxiayu@szu.edu.cn
Research Domain of This Article
Neurosciences
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Zheng-Yang Huang, Hao-Fan Huang, Shu-Hua Huang, Yi Gao, Xia-Xia Yu, School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen 518037, Guangdong Province, China
Yong Liu, Jing-Xin Wang, Jin-Fei Tian, Wen-Xian Zeng, Rong-Gui Lv, Song Jiang, Intensive Care Unit, Shenzhen Hospital, Southern Medical University, Shenzhen 518101, Guangdong Province, China
Jun-Ling Gao, Department of Medicine, LKS Medical Faculty, The University of Hong Kong, Hongkong 999077, China
Author contributions: Yu XX and Liu Y conceived and coordinated the study, designed, performed and analyzed the experiments, wrote the paper; Wang JX, Tian JF, Zeng WX, Jiang S and Lv RG carried out the data collection and preprocess of the raw data; Huang ZY, Huang HF and Huang SH performed the data analysis; Liu Y and Gao JL revised the paper; all authors reviewed the results and approved the final version of the manuscript.
Institutional review board statement: The study was approved by the Ethics Committee for Human Research of Shenzhen Hospital, Southern Medical University, No. YS2YYEC20180009.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xia-Xia Yu, PhD, Assistant Professor, School of Biomedical Engineering, Health Science Center, Shenzhen University, No. 1066 Xueyuan Avenue, Nanshan District, Shenzhen 518037, Guangdong Province, China. xiaxiayu@szu.edu.cn
Received: August 11, 2021 Peer-review started: August 11, 2021 First decision: October 20, 2021 Revised: November 30, 2021 Accepted: February 12, 2022 Article in press: February 12, 2022 Published online: March 26, 2022 Processing time: 223 Days and 10.5 Hours
Abstract
BACKGROUND
The exact definition of Acute kidney injury (AKI) for patients with traumatic brain injury (TBI) is unknown.
AIM
To compare the power of the “Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease” (RIFLE), Acute Kidney Injury Network (AKIN), Creatinine kinetics (CK), and Kidney Disease Improving Global Outcomes (KDIGO) to determine AKI incidence/stage and their association with the in-hospital mortality rate of patients with TBI.
METHODS
This retrospective study collected the data of patients admitted to the intensive care unit for neurotrauma from 2001 to 2012, and 1648 patients were included. The subjects in this study were assessed for the presence and stage of AKI using RIFLE, AKIN, CK, and KDIGO. In addition, the propensity score matching method was used.
RESULTS
Among the 1648 patients, 291 (17.7%) had AKI, according to KDIGO. The highest incidence of AKI was found by KDIGO (17.7%), followed by AKIN (17.1%), RIFLE (12.7%), and CK (11.5%) (P = 0.97). Concordance between KDIGO and RIFLE/AKIN/CK was 99.3%/99.1%/99.3% for stage 0, 36.0%/91.5%/44.5% for stage 1, 35.9%/90.6%/11.3% for stage 2, and 47.4%/89.5%/36.8% for stage 3. The in-hospital mortality rates increased with the AKI stage in all four definitions. The severity of AKI by all definitions and stages was not associated with in-hospital mortality in the multivariable analyses (all P > 0.05).
CONCLUSION
Differences are seen in AKI diagnosis and in-hospital mortality among the four AKI definitions or stages. This study revealed that KDIGO is the best method to define AKI in patients with TBI.
Core Tip: Because the exact definition of Acute Kidney Injury (AKI) for patients with Traumatic brain injury (TBI) is unknown, this study compared the power of four different AKI diagnose criteria to determine AKI incidence/stage and their association with the in-hospital mortality rate of patients with TBI.
