Hematuria in the burned child.
Hematuria is a frequent complication in burn patients, but its clinical significance has not been reported. The incidence, etiologies, treatment, and outcome of hematuria in 1,785 burn patients treated from 1964 to 1983, have been reviewed. Ninety-one patients had hematuria (greater than 15 RBC/HPF with unspun urine). There were five main causes: urinary infections (UTI), 50 cases; renal calculi (RC), 14 cases, including 3% and 5% total body surface area burn patients; catheter trauma, 7 cases; renal vein thrombosis (RVT), 5 cases; and acute renal failure (ATN), 4 cases. Ten patients died in the UTI group, five with Candida as the infecting organism. No RC patients died, but two required surgical extraction of their stones. This incidence of RC may be due to large intake of dairy products and antacids and to prolonged immobilization. The catheter trauma group had no deaths and was the youngest group. One RVT patient was diagnosed clinically and successfully treated surgically. The other three were diagnosed at necropsy. The ATN patients all developed renal failure late as part of multiple organ system failure and all died. We conclude hematuria is a serious finding in burn patients and prompt diagnosis of its etiology and treatment are essential for maintaining renal function and patient survival.
Tweddell
J S
JS
New York University Hospital, New York.
Waymack
J P
JP
Warden
G D
GD
Law
E J
EJ
Jenkins
M
M
Alexander
J W
JW
D058186:Acute Kidney Injury; D002056:Burns / Q000150:complications*; D002648:Child; D005260:Female; D006417:Hematuria / Q000209:etiology*; D006801:Humans; D007669:Kidney Calculi / Q000150:complications; D008297:Male; D012082:Renal Veins; D013927:Thrombosis / Q000150:complications; D014546:Urinary Catheterization / Q000009:adverse effects; D014552:Urinary Tract Infections / Q000150:complications