Acute posttraumatic renal failure: A multicenter perspective

J. A. Morris, P. Mucha, S. E. Ross, B. F A Moore, D. B. Hoyt, L. Gentilello, J. Landercasper, D. V. Feliciano, S. R. Shackford, E. J. Rutherford, T. R. Wilcox, M. Rhodes, K. A. Illig, E. E. Moore, R. Mackersie, G. Jurkovich, T. H. Cogbill, K. F. O'Malley, J. D. Schmoker, S. M. Bass

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Abstract

Acute renal failure (ARF) following trauma is rare. Historically, ARF has been associated with a high mortality rate. To investigate this entity we conducted a retrospective review of 72,757 admissions treated at nine regional trauma centers over a 5-year period. Seventy-eight patients (0.098%) developed acute renal failure requiring hemodialysis. Detailed demographic, clinical, and outcome data were collected. Patients with pre-existing medical conditions (group I) had a 70% increase in mortality over those without pre-existing conditions (p < 0.004). Twenty-four patients (31%) developed ARF less than 6 days after injury (group II). The remainder (group III) developed late renal failure (mean time to first dialysis, 23 days). The predominant cause of death was multiple organ failure (82%). There were no differences in mortality because of multiple organ failure among the three groups of patients. Of the 33 survivors, six (18%) were discharged with renal insufficiency, three (9%) were discharged on dialysis, 23 (70%) were discharged home or to rehabilitation, and 27 (82%) had no significant evidence of renal insufficiency. Conclusion: Posttraumatic renal failure requiring hemodialysis is rare (incidence, 107 per 100,000 trauma center admissions), but the mortality rate remains high (57%). Two thirds of the cases of posttraumatic renal failure develop late and are secondary to multiple organ failure; one third of the cases of posttraumatic renal failure develop early and may result from inadequate resuscitation.

Original languageEnglish (US)
Pages (from-to)1584-1590
Number of pages7
JournalJournal of Trauma
Volume31
Issue number12
Publication statusPublished - 1991

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ASJC Scopus subject areas

  • Surgery

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Morris, J. A., Mucha, P., Ross, S. E., Moore, B. F. A., Hoyt, D. B., Gentilello, L., ... Bass, S. M. (1991). Acute posttraumatic renal failure: A multicenter perspective. Journal of Trauma, 31(12), 1584-1590.