relation between proteinuria and acute kidney injury in patients with severe burns关系严重烧伤患者的蛋白尿和急性肾损伤.pdfVIP

Hu et al. Critical Care 2012, 16:R172 /content/16/5/R172 RESEARCH Open Access Relation between proteinuria and acute kidney injury in patients with severe burns 1† 2† 3 1 1 1 1 4 Jiong Yu Hu , Xin Chun Meng , Jian Han , Fei Xiang , Ya Dong Fang , Jun Wu , Yi Zhi Peng , Ya Zhou Wu , Yue Sheng Huang1 and Qi Zhi Luo1* Abstract Introduction: Proteinuria in burn patients is common, and may be associated with acute kidney injury (AKI) and adverse outcomes. We evaluated the incidences, outcomes, characteristics and determinants of proteinuria and its influence on AKI and outcomes in burn patients. Methods: This retrospective study was carried out in a hospital’s burn department. The study population consisted of patients with burn injuries admitted during a five-year period. Positive urine dipstick readings were defined as mild (± or 1+) or heavy (≥ 2+) proteinuria, and AKI was diagnosed and staged according to the Risk, Injury, Failure, Loss, End Stage (RIFLE) classification system. Patient characteristics, management and outcomes were evaluated for associations with proteinuria using nonparametric tests, chi-square (c2) tests and binary logistic regression. Results: Of the patients admitted to the burn unit during the study period (n = 2,497), 865 (34.64%) were classified as having proteinuria. In the patients whose total burn surface areas (TBSA) were 30% (n = 396), 271 patients (68.43%) had proteinuria and 152 of these patients (56.09%) met AKI criteria. No patients without proteinuria developed AKI. Intensive care unit (ICU) mortality rates were 0.8%, 16.67% and 30.77% (P 0.001) in the groups with no, mild and heavy proteinuria, respectively. Logistic regression analysis