The Changing Pattern of Acute Kidney Injury: From One to Multiple Organ Failure

Background. Acute kidney injury (AKI) treated with continuous renal replacement therapy (CRRT) is a severe complication in trauma patients. The aim of the study was to assess primary traumatic injuries and secondary organ failures in severe posttraumatic AKI.Methods. Retrospective review of adult trauma patients admitted to the trauma centre at Oslo University Hospital Ullevål. Injury severity score (ISS) was used to assess the severity of primary injuries, and sequential organ failure assessment (SOFA) score was utilized to measure secondary organ failures.Results. Forty-two (8%) of 506 trauma patients admitted to intensive care unit developed AKI treated with CRRT, whereof 40 (95%) suffered blunt trauma mechanisms. Patients had extensive primary organ injuries with median (interquartile range) ISS 36 (27–49). The majority of the patients had respiratory (93% intubated) and cardiovascular (67% with inotropic and/or vasoactive medication) failure within 24 hours after admission. AKI was often part of multiple organ failure, most frequently respiratory and cardiovascular failure, affecting 33 (75%) and 30 (71%) of the patients, respectively.Conclusion. Trauma patients with AKI undergoing CRRT often had severe primary injuries due to blunt trauma. Most of them suffered from secondary multiple organ failure concomitant to AKI.

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Thrombocytopenia-Associated Multiple Organ Failure and Acute Kidney Injury

Critical Care Clinics ◽

10.1016/j.ccc.2015.06.004 ◽

2015 ◽

Vol 31 (4) ◽

pp. 661-674 ◽

Cited By ~ 27

Author(s):

Trung C. Nguyen ◽

Miguel A. Cruz ◽

Joseph A. Carcillo

Keyword(s):

Acute Kidney Injury ◽

Multiple Organ Failure ◽

Organ Failure ◽

Kidney Injury ◽

Multiple Organ

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Perfluorocarbon solutions limit tubular epithelial cell injury and promote CD133+ kidney progenitor differentiation: potential use in renal assist devices for sepsis-associated acute kidney injury and multiple organ failure

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfx328 ◽

2017 ◽

Vol 33 (7) ◽

pp. 1110-1121 ◽

Cited By ~ 6

Author(s):

Vincenzo Cantaluppi ◽

Davide Medica ◽

Alessandro Domenico Quercia ◽

Sergio Dellepiane ◽

Federico Figliolini ◽

...

Keyword(s):

Acute Kidney Injury ◽

Epithelial Cell ◽

Multiple Organ Failure ◽

Organ Failure ◽

Cell Injury ◽

Kidney Injury ◽

Tubular Epithelial Cell ◽

Multiple Organ ◽

Differentiation Potential ◽

Potential Use

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Renal support therapy

The ESC Textbook of Intensive and Acute Cardiovascular Care ◽

10.1093/med/9780198849346.003.0028 ◽

2021 ◽

pp. 338-350

Author(s):

Claudio Ronco ◽

Stefano Romagnoli ◽

Zaccaria Ricci

Keyword(s):

Acute Kidney Injury ◽

Renal Replacement Therapy ◽

Multiple Organ Failure ◽

Replacement Therapy ◽

Kidney Injury ◽

Multiple Organ ◽

Acute Illness ◽

Renal Support Therapy ◽

Critical Patients ◽

Renal Support

Renal dysfunction is known to be frequently a component of multiple organ failure, a complex syndrome affecting the most severely ill critical patients. Bidirectional interaction between the kidneys and other organs has always been suspected; evidence suggests that severe kidney injury is an important protagonist in acute illness, even when managed by dialysis. In fact, if it seems that increasing the dose of renal replacement therapy does not reduce mortality, it could be inferred that acute kidney injury influences mortality through means that are not reversed by conventional renal support, either because the putative culprit toxins are not removed by renal replacement therapy or because renal replacement therapy is started too late to prevent these effects. It is known that the kidneys exert effects on other organs, such as the lung, liver, heart, and brain, in a process called 'crosstalk'. This effect means that the kidney is not only a victim, but also a culprit regarding the malfunction of other organs. This chapter will detail some traditional aspects of different renal replacement therapy modalities and prescription schedules, but it will also describe the most recent evidence on the management and support of the kidney during failure of other organs.

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Renal support therapy

10.1093/med/9780199687039.003.0029_update_001 ◽

2016 ◽

Author(s):

Claudio Ronco ◽

Zaccaria Ricci

Keyword(s):

Acute Kidney Injury ◽

Renal Replacement Therapy ◽

Multiple Organ Failure ◽

Replacement Therapy ◽

Kidney Injury ◽

Multiple Organ ◽

Acute Illness ◽

Renal Support Therapy ◽

Critical Patients ◽

Renal Support

Renal dysfunction is known to be frequently a component of multiple organ failure, a complex syndrome affecting the most severely ill critical patients. Bidirectional interaction between the kidneys and other organs has always been suspected; evidence suggests that severe kidney injury is an important protagonist in acute illness, even when managed by dialysis. In fact, if it seems that increasing the dose of renal replacement therapy does not reduce mortality, it could be inferred that acute kidney injury influences mortality through means that are not reversed by conventional renal support, either because the putative culprit toxins are not removed by renal replacement therapy or because renal replacement therapy is started too late to prevent these effects. It is known that the kidneys exert effects on other organs, such as the lung, liver, heart, and brain, in a process called ‘crosstalk’. This effect means that the kidney is not only a victim, but also a culprit regarding the malfunction of other organs. This chapter will detail some traditional aspects of different renal replacement therapy modalities and prescription schedules, but it will also describe the most recent evidence on the management and support of the kidney during failure of other organs.

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Renal support therapy

10.1093/med/9780199687039.003.0029 ◽

2015 ◽

Author(s):

Claudio Ronco ◽

Zaccaria Ricci

Keyword(s):

Acute Kidney Injury ◽

Renal Replacement Therapy ◽

Multiple Organ Failure ◽

Replacement Therapy ◽

Kidney Injury ◽

Multiple Organ ◽

Acute Illness ◽

Renal Support Therapy ◽

Critical Patients ◽

Renal Support

Renal dysfunction is known to be frequently a component of multiple organ failure, a complex syndrome affecting the most severely ill critical patients. Bidirectional interaction between the kidneys and other organs has always been suspected; evidence suggests that severe kidney injury is an important protagonist in acute illness, even when managed by dialysis. In fact, if it seems that increasing the dose of renal replacement therapy does not reduce mortality, it could be inferred that acute kidney injury influences mortality through means that are not reversed by conventional renal support, either because the putative culprit toxins are not removed by renal replacement therapy or because renal replacement therapy is started too late to prevent these effects. It is known that the kidneys exert effects on other organs, such as the lung, liver, heart, and brain, in a process called ‘crosstalk’. This effect means that the kidney is not only a victim, but also a culprit regarding the malfunction of other organs. This chapter will detail some traditional aspects of different renal replacement therapy modalities and prescription schedules, but it will also describe the most recent evidence on the management and support of the kidney during failure of other organs.

Download Full-text