Skip Navigation
Skip to contents

J Trauma Inj : Journal of Trauma and Injury

OPEN ACCESS
SEARCH
Search

Search

Page Path
HOME > Search
6 "Kidney injury"
Filter
Filter
Article category
Keywords
Publication year
Authors
Case Reports
Successful nonoperative management of a simultaneous high-grade splenic injury and devascularized kidney in Australia: a case report
Peter Thanh Tam Nguyen, Jeremy M. Hsu
J Trauma Inj. 2023;36(4):431-434.   Published online September 7, 2023
DOI: https://doi.org/10.20408/jti.2023.0017
  • 581 View
  • 11 Download
AbstractAbstract PDF
Severe blunt injuries to isolated solid abdominal viscera have been previously managed nonoperatively; however, management algorithms for simultaneous visceral injuries are less well defined. We report a polytrauma case of a 33-year-old man involved in a motorbike collision who presented with left-sided chest and abdominal pain. Initial imaging demonstrated multiple solid organ injuries with American Association for the Surgery of Trauma (AAST) grade V splenic injury and complete devascularization of the left kidney. The patient underwent urgent angioembolic coiling of the distal splenic artery with successful nonoperative management of simultaneous grade V solid organ injuries.
Summary
Atypical Hemolytic Uremic Syndrome after Traumatic Rectal Injury: A Case Report
Ji-Hyoun Kang, Donghyun Lee, Yunchul Park
J Trauma Inj. 2021;34(4):299-304.   Published online September 1, 2021
DOI: https://doi.org/10.20408/jti.2020.0068
  • 2,691 View
  • 64 Download
AbstractAbstract PDF

Atypical hemolytic uremic syndrome (aHUS) is a rare, progressive, life-threatening condition of thrombotic microangiopathy characterized by thrombocytopenia, microangiopathic hemolytic anemia, and renal impairment. The mechanisms underlying aHUS remain unclear. Herein, we present the first case in the literature of aHUS after a traumatic injury. A 55-year-old male visited the emergency department after a traumatic injury caused by a tree limb. Abdominal computed tomography revealed a rectal wall defect with significant air density in the perirectal space and preperitoneum, implying rectal perforation. Due to the absence of intraperitoneal intestinal perforation, we performed diverting sigmoid loop colostomy. An additional intermittent simple repair was performed due to perianal and anal injuries. One day postoperatively, his urine output abruptly decreased and serum creatinine level increased. His platelet level decreased, and a spiking fever occurred after 2 days. The patient was diagnosed with acute renal failure secondary to aHUS and was treated with fresh frozen plasma replacement. Continuous renal replacement therapy (CRRT) was also started for oliguria and uremic symptoms. The patient received CRRT for 3 days and intermittent hemodialysis thereafter. After hemodialysis and subsequent supportive treatment, his urine output and renal function improved. The hemolytic anemia and thrombocytopenia also gradually improved. Dialysis was terminated on day 22 of admission and the patient was discharged after recovery. This case suggests that that a traumatic event can trigger aHUS, which should be considered in patients who have thrombocytopenia and acute renal failure with microangiopathic hemolytic anemia. Early diagnosis and appropriate management are critical for favorable outcomes.

Summary
Original Articles
Role of the Neutrophil-to-Lymphocyte Ratio at the Time of Arrival at the Emergency Room as a Predictor of Rhabdomyolysis in Severe Trauma Patients
Jin Chul Bae, Kyung Hoon Sun, Yong Jin Park
J Trauma Inj. 2020;33(2):96-103.   Published online June 17, 2020
DOI: https://doi.org/10.20408/jti.2020.018
  • 5,767 View
  • 96 Download
AbstractAbstract PDF
Purpose

In patients with trauma, rhabdomyolysis (RM) can lead to fatal complications resulting from muscle damage. Thus, RM must be immediately diagnosed and treated to prevent complications. Creatine kinase (CK) is the most sensitive marker for diagnosing RM. However, relying on CK tests may result in delayed treatment, as it takes approximately 1 hour to obtain CK blood test results. Hence, this study investigated whether the neutrophil-to-lymphocyte ratio (NLR) could predict RM at an earlier time point in patients with trauma, since NLR results can be obtained within 10 minutes.

Methods

This retrospective study included 130 patients with severe trauma who were admitted to the emergency room of a tertiary institution between January 2017 and April 2020. RM was defined as a CK level ≥1,000 U/L at the time of arrival. Patients with severe trauma were categorized into non-RM and RM groups, and their characteristics and blood test results were analyzed. Statistical analysis was performed using SPSS version 26.0 for Windows.

Results

Of the 130 patients with severe trauma, 50 presented with RM. In the multivariate analysis, the NLR (odds ratio [OR], 1.252; 95% confidence interval [CI], 1.130– 1.386), pH level (OR, 0.006; 95% CI, 0.000–0.198), presence of acute kidney injury (OR, 3.009; 95% CI, 1.140–7.941), and extremity Abbreviated Injury Scale score (OR, 1.819; 95% CI, 1.111–2.980) significantly differed between the non-RM and RM groups. A receiver operating characteristic analysis revealed that a cut-off NLR value of 3.64 was the best for predicting RM.

Conclusions

In patients with trauma, the NLR at the time of arrival at the hospital is a useful biochemical marker for predicting RM.

Summary
Early Predictive Values for Severe Rhabdomyolysis in Blunt Trauma
Jung Yun Park, Myoung Jun Kim, Jae Gil Lee
J Trauma Inj. 2019;32(1):26-31.   Published online March 31, 2019
DOI: https://doi.org/10.20408/jti.2018.029
  • 4,797 View
  • 129 Download
  • 2 Citations
AbstractAbstract PDF
Purpose

Rhabdomyolysis (RB) is a syndrome characterized by the decomposition of striated muscles and leakage of their contents into the bloodstream. Acute kidney injury (AKI) is the most significant and serious complication of RB and is a major cause of mortality in patients with RB. Severe RB (creatine kinase [CK] ≥5,000) has been associated with AKI. However, early prediction is difficult because CK can reach peak levels 1?3 days after the trauma. Hence, the aim of our study was to identify predictors of severe RB using initial patient information and parameters.

Methods

We retrospectively analyzed 1,023 blunt trauma patients admitted to a single tertiary hospital between August 2011 and March 2018. Patients with previously diagnosed chronic kidney disease were excluded from the study. RB and severe RB were defined as a CK level ≥1,000 U/L and ≥5,000 U/L, respectively. The diagnosis of AKI was based on RIFLE criteria.

Results

The overall incidence of RB and severe RB was 31.3% (n=320) and 6.2% (n=63), respectively. On multivariable analysis, male sex (odds ratio [OR] 3.78, 95% confidence interval [CI] 1.43 to 10.00), initial base excess (OR 0.85, 95% CI 0.80 to 0.90), initial CK (OR 2.07, 95% CI 1.67 to 2.57), and extremity abbreviated injury scale score (OR 1.78, 95% CI 1.39 to 2.29) were found to predict severe RB. The results of receiver operating characteristic analysis showed that the best cutoff value for the initial serum CK level predictive of severe RB was 1,494 U/L.

Conclusions

Male patients with severe extremity injuries, low base excess, and initial CK level >1,500 U/L should receive vigorous fluid resuscitation.

Summary

Citations

Citations to this article as recorded by  
  • Factors Associated with Acute Kidney Injury Occurrence and Prognosis in Rhabdomyolysis at the Emergency Department
    Jun Seok Seo, Inhwan Yeo, Changho Kim, Daeun Kim, Jeong-Hoon Lim, Kyoungtae Park, Jiwoo Jeong, Hojin Kwon, Yuna Cho, Sungyeon Park
    Medicina.2024; 60(1): 105.     CrossRef
  • Role of the Neutrophil-to-Lymphocyte Ratio at the Time of Arrival at the Emergency Room as a Predictor of Rhabdomyolysis in Severe Trauma Patients
    Jin Chul Bae, Kyung Hoon Sun, Yong Jin Park
    Journal of Trauma and Injury.2020; 33(2): 96.     CrossRef
Comparative Analysis between Spinning and Other Causes in Exercise-Induced Rhabdomyolysis
Do Won Shim, Sung Youl Hyun, Jae Hyug Woo, Jae Ho Jang, Jae Yeon Choi
J Trauma Inj. 2018;31(3):159-165.   Published online December 31, 2018
DOI: https://doi.org/10.20408/jti.2018.038
  • 3,291 View
  • 40 Download
  • 1 Citations
AbstractAbstract PDF
Purpose

Spinning-induced rhabdomyolysis (SIR) has been increasing in recent years and accounts for a large proportion of exercise-induced rhabdomyolysis (EIR). The purpose of this study was to compare the clinical features between SIR and non-spinning exercise-induced rhabdomyolysis (NSIR), and to analyze each of these clinical features.

Methods

A retrospective chart review was conducted on patients treated due to EIR from January 2006 to March 2018. Patients were divided into the SIR and NSIR groups, and their clinical factors, outcome, and blood chemistries were compared and analyzed.

Results

Sixty-two patients were enrolled in this study, with 23 (37.1%) and 39 (62.9%) patients categorized in the SIR and NSIR groups, respectively. The SIR group were mostly women (78.3% vs. 38.5%, p=0.002), more f requent EIR occurrence in the first exercise class (60.9% vs. 15.4%, p=0.001), and had most complaints of thigh pain (91.3% vs. 43.6%, p=0.001). The SIR group had a higher incidence rate despite its shorter exercise duration (90.5% vs. 62.9%, p=0.024), longer hospital stay (6.0 [4.5?7.0] vs. 5.0 [3.5?6.0] days, p=0.080), and higher rate of peak CPK (15,000 U/L or higher) (91.3% vs. 74.4%, p=0.182) compared to the NSIR group.

Conclusions

SIR occurs at a higher rate during the first exercise class in women compared to NSIR, and the incidence rate is higher in SIR than in NSIR despite its shorter exercise duration (less than 60 minutes). It is necessary to recognize these risks during spinning exercises and to perform these exercises sequentially and systematically.

Summary

Citations

Citations to this article as recorded by  
  • Clinical characteristics and outcomes of exertional rhabdomyolysis after indoor spinning: a systematic review
    Yoshio Masuda, Rachel Wam, Benjamin Paik, Clara Ngoh, Andrew MTL Choong, Jun Jie Ng
    The Physician and Sportsmedicine.2023; 51(4): 294.     CrossRef
Management of High-grade Blunt Renal Trauma
Min A Lee, Myung Jin Jang, Gil Jae Lee
J Trauma Inj. 2017;30(4):192-196.   Published online December 30, 2017
DOI: https://doi.org/10.20408/jti.2017.30.4.192
  • 4,208 View
  • 162 Download
  • 5 Citations
AbstractAbstract PDF
Purpose

Blunt injury accounts for 80?95% of renal injury trauma in the United States. The majority of blunt renal injuries are low grade and 80?85% of these injuries can be managed conservatively. However, there is a debate on the management of patients with high-grade renal injury. We reviewed our experience of renal trauma at our trauma center to assess management strategy for high-grade blunt renal injury.

Methods

We reviewed blunt renal injury cases admitted at a single trauma center between August 2007 and December 2015. Computed tomography (CT) scan was used to diagnose renal injuries and high?grade (according to the American Association for the Surgery of Trauma [AAST] organ injury scale III?V) renal injury patients were included in the analysis.

Results

During the eight?year study period, there were 62 AAST grade III?V patients. 5 cases underwent nephrectomy and 57 underwent non-operative management (NOM). There was no difference in outcome between the operative group and the NOM group. In the NOM group, 24 cases underwent angioembolization with a 91% success rate. The Incidence of urological complications correlated with increasing grade.

Conclusions

Conservative management of high-grade blunt renal injury was considered preferable to operative management, with an increased renal salvage rate. However, high-grade injuries have higher complication rates, and therefore, close observation is recommended after conservative management.

Summary

Citations

Citations to this article as recorded by  
  • Functional range of the kidney after a low-severity injury: a randomized study
    K. A. Chiglintsev, A. V. Zyryаnov, A. Yu. Chiglintsev, A. A. Makarian
    Diagnostic radiology and radiotherapy.2023; 14(2): 74.     CrossRef
  • Outcome of Kidney Trauma Management: Experiences from a Tertiary Referral Hospital in East Indonesia
    Yufi Aulia Azmi, Danang Irsayanto, Kevin Muliawan Soetanto, Johan Renaldo, Soetojo Wirjopranoto
    Biomolecular and Health Science Journal.2023; 6(2): 135.     CrossRef
  • RENAL TRAUMA: PROFILE AND MANAGEMENT
    Vipul Bakshi, Tariq A Mir, Harmandeep Singh Chahal
    GLOBAL JOURNAL FOR RESEARCH ANALYSIS.2022; : 109.     CrossRef
  • Management of renal injury in a UK major trauma centre
    Robert Torrance, Abigail Kwok, David Mathews, Matthew Elliot, Andrew Baird, Marc A Lucky
    Trauma.2020; 22(1): 26.     CrossRef
  • Renal trauma: a 5-year retrospective review in single institution
    Syarif, Achmad M. Palinrungi, Khoirul Kholis, Muhammad Asykar Palinrungi, Syakri Syahrir, Reinaldo Sunggiardi, Muhammad Faruk
    African Journal of Urology.2020;[Epub]     CrossRef

J Trauma Inj : Journal of Trauma and Injury