Kidney disease improving global outcome for predicting acute kidney injury in traumatic brain injury patients

Aim To determine the incidence of acute kidney injury (AKI) based on Kidney Disease Improving Global Outcome (KDIGO) criteria in patients with severe traumatic brain injury and to study AKI in relation to risk factors and outcomes. Method This trial was a descriptive analytic study on 83 patients with severe traumatic brain injury admitted to Poursina Hospital (Rasht, Iran). The incidence of AKI was determined based on KDIGO criteria over a 12-month period. The correlation of mortality rates, multi-organ failure (MOF), and neurologic outcome to AKI were studied. Results Of 83 eligible patients who entered the study, 25.3% ( N = 21) developed AKI based on KDIGO criteria. Glasgow Outcome Scale on admission was the only risk factor significantly associated with the incidence of AKI ( p = 0.001). Mortality rates (62% vs. 22.6%, p = 0.002) and the occurrence of MOF were significantly higher in patients who developed AKI (23.8% vs. 0% MOF based on Sequential Organ Failure Assessment, p < 0.0001; 19% vs. 0% MOF based on Multiple Organ Dysfunction score, p < 0.0001). Poor neurologic outcome was observed in 95% and 92% of patients with and without AKI, respectively ( p = 0.674). Conclusion The incidence of AKI among patients with severe traumatic brain injury is striking. The association of Glasgow Outcome Scale with AKI helps to identify patients at a higher risk of developing AKI. Significant rates of mortality and MOF among patients with severe traumatic brain injury and AKI, necessitates consideration of renoprotective measures from the early days of hospital admission.