Kidney injury: A serious risk to the health and survival of today's soldiers

December 08, 2011

Washington, DC (December 8, 2011) -- Acute kidney injury (AKI), an abrupt or rapid decline in kidney function, is a serious and increasingly prevalent condition. Little information has been available about how common or how severe AKI is in military personnel who are injured during combat in Iraq and Afghanistan. A new study appearing in an upcoming issue of the Clinical Journal of the American Society Nephrology (CJASN) investigates this question in those burned during combat.

Captain Ian Stewart, MD, USAF (San Antonio Military Medical Center, Fort Sam Houston) and his colleagues examined military casualties who were evacuated from Iraq and Afghanistan to burn units. When they used two different classification systems for AKI, the researchers found that AKI prevalence rates were 23.8% (according to one system) and 29.9% (according to the other) among 692 evacuated casualties. Patients with AKI were much more likely to die than patients without AKI: the death rates among patients with moderate and severe AKI were 21.4% to 33.3% and 62.5%to 65.1%, respectively, compared with 0.2% among patients without AKI.

The majority of patients (57.6%) were diagnosed with AKI when they were admitted to the hospital, implying that factors related to combat may be responsible. Conversely, for patients who developed AKI after the first week (17.6%), complications from their hospitalization were likely the cause. Patients in the intermediate time range (24.8%) probably had some combination of factors.

"Our research shows that if a wounded warrior develops kidney damage, he or she is at an increased risk of dying," said Dr. Stewart. "By preventing or modifying kidney injury, we may be able to improve survival in military personnel with burns and/or other traumatic injury," he added. Additional studies are needed to test whether intervening to reduce AKI will save lives.
-end-
Study co-authors include Molly Tilley, MD, USAF, Casey Cotant, MD, Hana Kwan, MD, USAF (San Antonio Military Medical Center, Fort Sam Houston); James Aden, PhD, Jeffery McCorcle, Evan Renz, MD, USA, Kevin Chung, MD, USA (US Army Institute of Surgical Research, Fort Sam Houston); and Christopher Gisler, MD (University of Texas Health Science Center at San Antonio).

Disclosures: The authors reported no financial disclosures.

The article, entitled "Association of AKI with Adverse Outcomes in Burned Military Casualties," will appear online at http://cjasn.asnjournals.org/ on December 8, 2011, doi: 10.2215/CJN.04420511.

The content of this article does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the author(s). ASN does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.

Founded in 1966, and with more than 12,000 members, the American Society of Nephrology (ASN) leads the fight against kidney disease by educating health professionals, sharing new knowledge, advancing research, and advocating the highest quality care for patients.

American Society of Nephrology

Related Kidney Function Articles from Brightsurf:

Cancer drug can rebalance kidney function in a devastating genetic disease
Researchers at the University of Cambridge and the University of Zurich have discovered that a drug newly approved for cancer improves kidney dysfunction in a mouse model of Dent disease 2 and Lowe syndrome

SphingoTec's kidney function biomarker penKid® accurately detects acute kidney injury in infants
penKidĀ® (Proenkephalin), a unique biomarker for the real-time assessment of kidney function.

Use of cystatin C for precise assessment of kidney function and cardiovascular risk
In many situations, it is essential that the physician knows a patient's kidney function as precisely as possible.

Young sugarcane workers at high risk of kidney function decline
Researchers from the Center for Health, Work and Environment (CHWE) at the Colorado School of Public Health have published a paper in PLoS-ONE, studying the decline in kidney function for young, first-time sugarcane workers in Guatemala.

Protein levels in urine after acute kidney injury predict future loss of kidney function
High levels of protein in a patient's urine shortly after an episode of acute kidney injury is associated with increased risk of kidney disease progression, providing a valuable tool in predicting those at highest risk for future loss of kidney function.

Kidney function may affect risks associated with prescription opioids
Compared with other pain medications, prescription opioids were linked with higher risks of death and hospitalization, particularly with higher doses.

Comparing major adverse cardiovascular events among patients with diabetes, reduced kidney function treated with metformin or sulfonylurea
This observational study compared major cardiovascular events (including hospitalization for heart attack, stroke, transient ischemic attack or cardiovascular death) among patients with diabetes and reduced kidney function treated with metformin or a sulfonylurea (a class of drugs to treat diabetes).

Fluoride may diminish kidney and liver function in adolescents, study suggests
luoride exposure may lead to a reduction in kidney and liver function among adolescents, according to a study published by Mount Sinai researchers in Environment International in August.

Higher kidney function at dialysis start linked with greater risk of death in children
In an analysis of information on children with kidney failure who began dialysis in the United States between 1995 and 2015, the risk of death was 1.36 times higher among children with higher kidney function at dialysis initiation.

Indigestion remedy slows kidney function decline and improves survival in late-stage CKD
As chronic kidney disease (CKD) progresses, the kidneys become less able to maintain a healthy balance of acids in the body.

Read More: Kidney Function News and Kidney Function Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.