Clinical characteristics of acute renal failure occurring in major burns.
- Author:
Sung Wook KIM
1
;
Young Hoon MIN
;
Hui Jong CHIN
;
Tae Yu LEE
;
Chang Soon CHOI
;
Youn Son CHUNG
;
Gun Sook KIM
;
Gheun Ho KIM
;
Jong Hyun KIM
;
Yoon Kyu PARK
Author Information
1. Department of Internal Medicine, College of Medicine, Hallym University Hangang Sacred Heart Hospital, Seoul, Korea. gheunho@hanmail.net
- Publication Type:Original Article
- Keywords:
Acute renal failure;
Burn;
Albumin;
Burn size;
Mortality
- MeSH:
Acute Kidney Injury*;
Adult;
Aminoglycosides;
Body Surface Area;
Burns*;
Creatinine;
Humans;
Hypotension;
Intensive Care Units;
Korea;
Logistic Models;
Mortality;
Retrospective Studies;
Rhabdomyolysis;
Seoul;
Sepsis;
Serum Albumin
- From:Korean Journal of Medicine
2002;63(5):539-545
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Acute renal failure (ARF) is not a rare occurrence in severe burns and is an important complication leading to an increase in mortality. This study was undertaken to characterize the ARF occurring in major burn patients and to investigate the impact of burn size and initial serum albumin concentration on the occurrence of ARF and patient survival in major burns. METHODS: The clinical characteristics of 147 adult patients with second- and third-degree burns covering 30% or more of their body surface area were analyzed retrospectively. All patients were admitted over a 1-year period to a single burn intensive care unit in Seoul, Korea. Logistic regression was used to estimate of the relative risks of ARF and mortality associated with the larger burn size and the lower serum albumin level at admission. RESULTS: Mean burned body surface was 60.0+/-21.8% (range, 30 to 100%). Twenty-eight (19.0%) out of 147 patients experienced ARF, defined as a serum creatinine > 2 mg/dL, during the admission. The ARF was preceded by significant hypotension (burn shock), rhabdomyolysis, sepsis or use of aminoglycosides. The occurrence of ARF was not associated with age, sex or burn type. The patients with ARF had larger burn size (79.5+/-15.4% vs. 55.3+/-20.5%, p<0.0001) and lower serum albumin concentration at admission (1.92+/-0.66 g/dL vs. 2.48+/-0.82 g/dL, p<0.0005) compared with those without ARF. All patients with ARF expired, whereas 29.4% (35/119) of the patients without ARF died. The burn size > 65% was associated with a risk of ARF that was 9.9 times and with a risk of death that was 14.2 times as high as that for the burn size < 65%. The initial serum albumin level < 2.5 g/dL was associated with a risk of death that was 2.7 times as high as that for the initial serum albumin level > 2.5 g/dL. CONCLUSION: When major burns are complicated by ARF, the mortality increases very high. Burn size is an independent predictor of ARF occurring in major burns. Initially depressed serum albumin level is associated with an increase in mortality in the major burn patients.
