Management and Outcomes of Acute Kidney Injury due to Burns: A Literature Review.

Vardhan Avasarala, Matthew Satariano, Rupesh Raina, Javier A Neyra, Anjay Khandelwal, Kush Doshi, Pushan Aggarwal, Aneil Sood, Shyam Bansal

Journal: Journal of burn care & research : official publication of the American Burn Association 2024;45(2):323-337

PMID: 37565542

Abstract

Acute kidney injury (AKI), a common and severe complication following burn injuries, presents a significant challenge due to its broad clinical manifestations and diverse etiologies. AKI, previously known as acute renal failure, can present abruptly following burns or thermal injuries, causing detrimental health outcomes such as progressive kidney dysfunction, increased hospital length of stay, and requirement of renal replacement therapy (RRT). AKI affects the maintenance of homeostasis of fluid and electrolytes, elimination of metabolic wastes and byproducts, and acid-base balance. Aggressive nutritional support is particularly necessitated in burn patients to prevent protein-energy wasting and a negative nitrogen balance. Understanding the pathogenesis of AKI in burns and improving its prevention and early diagnosis are active areas of research in this field. Despite the potential benefits, the optimal timing and threshold for RRT initiation in burn patients with AKI remain unclear, warranting further studies. Ongoing investigations focus on refining RRT techniques, evaluating biomarkers for early detection of AKI, and exploring adjunctive therapies to enhance renal recovery. The aim of this study is to review the etiology, diagnostic tools, and interventions that improve outcomes associated with AKI in burn-related settings.

© The Author(s) 2023. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For permissions, please e-mail: [email protected].

Address: Department of Surgery, Division of Burn Surgery/Paul and Carol David Foundation Burn Institute, Akron Children's Hospital, Akron, OH 44308-1062, USA.; Northeast Ohio Medical University, Rootstown, OH 44272, USA.; Akron Nephrology Associates/Cleveland Clinic Akron General Medical Center, Akron, OH 44307, USA.; Department of Surgery, Summa Health, Akron, OH 44304, USA.; Institute of Kidney and Urology, Medanta, The Medicity, Gurgaon, Haryana 122001, India.; Department of Medicine, Division of Nephrology, University of Alabama at Birmingham, Birmingham, AL 35294-0007, USA.; Akron Nephrology Associates/Cleveland Clinic Akron General Medical Center, Akron, OH 44307, USA.; Department of Nephrology, Akron Children's Hospital, Akron, OH 44308, USA.
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