Acute kidney injury associated with burn damage
Acute kidney injury is a common complication of severe thermal injury with a frequency and mortality rate of up to 30% and 80%. Acute kidney damage is a polyetiological clinical disease, which makes it difficult to identify and diagnose it. The KDIGO consensus determines the stage and severity of AKI based on changes in serum creatinine and urine output over time. Acute renal damage associated with thermal damage is classified as early (0-3 days after injury) or later (4-14 days after injury). Early acute kidney damage associated with thermal damage is usually due to hypovolemia, insufficient renal perfusion, direct suppression of cardiac activity by tumor necrosis factor-alpha, and precipitation of denatured proteins, while late acute kidney damage is often due to sepsis, multiple organ failure and action nephrotoxic drugs. Diagnosis can be difficult, as diuresis and biochemical markers can be relatively normal even with significant damage to the kidneys. Therefore, a sensitive and specific biomarker is essential for the early diagnosis of acute kidney damage, and many potential biomarkers are being studied. For treatment, the primary cause is the elimination of the underlying cause of the disease. The advent of renal replacement therapy has significantly reduced the mortality of burn patients with AKI and should be started earlier if the injury progresses, despite the initial maneuvers. Preliminary data on the burn population suggest that AKI may lead to an increased risk of end-stage renal failure and an increase in mortality, but further studies are needed