Predictive factors for acute renal failure in crush injuries in the Sichuan earthquake.
BACKGROUND
The Sichuan earthquake caused a large number of crush injuries and many of them developed acute renal failure (ARF). A retrospective study was performed on victims with crush injuries of West China Hospital to investigate the predictive factors for acute renal failure (ARF) in crush injuries.


METHODS
Medical records of injured victims treated in West China Hospital within the first week after the Sichuan earthquake were retrospectively reviewed and 101 patients with crush injury were enrolled in the study. We divided them into an ARF group and a non-ARF group. The clinical data of included patients were extracted and analysed.


RESULTS
Patients with ARF accounted for 42% of the included population. Patients younger than 20 made up the biggest age category (45%), and the entrapped time under the debris (22 [IQR 3.5-38]h) was longer than previous reports. In univariate analysis, male gender, multiple crush injuries, medical comorbidities, surgical interventions and infections were more frequent in patients with ARF than in those without ARF. Mean arterial pressure was higher in the ARF group. Besides, the risk of ARF was increased by creatine kinase >14,494.5IU/L most significantly, followed by time under the rubble >4h, aspartate transaminase >453.5IU/L, albumin <27.15g/L and white blood cell >11.8×10(9)/L. In multivariate analysis, male gender, time under the rubble, multiple crush injuries, surgical interventions, infections and creatine kinase level were independently associated with ARF in crush injuries.


CONCLUSIONS
The entrapped time under the debris, multiple crush injuries, male gender, infections, and creatine kinase level are predictive factors for ARF in crush injuries.
Hu
Zhangxue
Z
Department of Nephrology, West China Hospital of Sichuan University, No. 37 Guoxue Xiang, Chengdu 610041, China.
Zeng
Xiaoxi
X
Fu
Ping
P
Luo
Zhijuan
Z
Tu
Yuanmao
Y
Liang
Jingyuan
J
Tao
Ye
Y
Qin
Wei
W
D058186:Acute Kidney Injury / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D000293:Adolescent; D000328:Adult; D001219:Aspartate Aminotransferases / Q000378:metabolism; D002648:Child; D002681:China / Q000453:epidemiology; D003402:Creatine Kinase / Q000378:metabolism; D003444:Crush Syndrome / Q000150:complications*; D004190:Disasters; D055866:Earthquakes; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012737:Sex Factors; D013997:Time Factors; D055815:Young Adult
D001219:Aspartate Aminotransferases; D003402:Creatine Kinase