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AN OBSERVATIONAL STUDY TO ASSESS THE TREATMENT OF ACUTE KIDNEY INJURY DUE TO HYPOVOLEMIA IN BURN PATIENTS

Dr Sayed Sultan Emad, Dr Muhammad Bin Mehroze Khan, Dr Ahmad Walid, Dr Zahoor Ahmed

Acute kidney injury (AKI) after severe burns is historically associated with a high mortality. Over the past two decades, various modes of renal replacement therapy (RRT) have been used in this population. The purpose of this multicenter study was to evaluate demographic, treatment, and outcomes data among severe burn patients treated with RRT (renal replacement therapy) collectively in burn unit at Mayo Hospital Lahore. Methods: This is an observational study. After institutional review board approval, an observational study was conducted. All adult patients aged 18 or older, admitted with severe burns that were placed on RRT for acute indications but not randomized into a concurrently enrolling interventional trial, were included. 71 subjects were enrolled during a 2 month period. Complete data were available in 70 subjects with a mean age of 51 ± 17, percent total body surface area burn of 38 ± 26% and injury severity score of 27 ± 21. Eighty percent of subjects were male and 34% were diagnosed with smoke inhalation injury. The preferred mode of therapy was continuous venovenous hemofiltration at a mean delivered dose of 37 ± 19 (ml/kg/hour) and a treatment duration of 13 ± 24 days. Result: Overall, in hospital, mortality was 50%. Among survivors, 21% required RRT on discharge from the hospital while 9% continued to require RRT 6 months after discharge. Overall mortality is comparable to other critically ill populations who undergo RRT. Most patients who survive to discharge eventually recover renal function. Conclusion: Most patients who survived to discharge eventually recovered renal function. Timely initiation of RRT with an individualized preference towards continuous modes at relatively higher than recommended doses has become standard practice in critically ill burns with AKI and is associated with a historically low mortality. Keywords: AKI (Acute Kidney Injury), Replacement, Burns.

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