title: Renal dysfunction in burns: a review.
abstract: Acute kidney injury (AKI), although rare, is a major complication of burn injury that commonly leads to mortality. It results from a complex interplay of various cellular and neuro-humoral changes affecting burn patients. Guidelines for the treatment of this entity are still not well defined; therefore, prevention and early diagnosis are key to avoid the unfavorable prognosis of AKI. These entail a comprehensive understanding of the global physiologic changes underlying the condition of burn patients and a judicious interpretation of their continuous homeostatic alterations. The aim of this review is to present the salient features in burn patient physiology that contribute to AKI. Strategies for identifying early AKI are presented. Finally, the different treatment modalities are revisited.
authors: Department of Surgery, Division of Burns, Massachusetts General Hospital, Harvard Medical School; Boston, Massachusetts, USA.
authors: A E
authors: AE
authors: Ibrahim
authors: K A
authors: KA
authors: Sarhane
authors: S P
authors: SP
authors: Fagan
authors: J
authors: J
authors: Goverman
keywords: classification of kidney injury; dialysis in burns; kidney dysfunction in burns; renal failure in burns; treatment of renal failure
references: JAMA. 2005 Apr 13;293(14):1737-45
references: 15827312
references: Intensive Care Med. 2010 Jun;36(6):915-25
references: 20333353
references: N Engl J Med. 2001 Nov 8;345(19):1368-77
references: 11794169
references: Mol Med. 2008 Sep-Oct;14(9-10):553-60
references: 18548133
references: Curr Opin Crit Care. 2006 Dec;12(6):538-43
references: 17077683
references: J Trauma. 1988 Oct;28(10):1464-7
references: 3172306
references: J Burn Care Rehabil. 1997 Sep-Oct;18(5):402-5
references: 9313119
references: Kidney Int Suppl. 1999 Nov;(72):S79-83
references: 10560812
references: J Trauma. 2002 Dec;53(6):1129-33; discussion 1133-4
references: 12478039
references: J Burn Care Res. 2006 Jul-Aug;27(4):448-51
references: 16819346
references: Ann Surg. 1982 Nov;196(5):594-7
references: 7125746
references: Am J Surg. 1971 Oct;122(4):524-7
references: 5098659
references: Curr Opin Crit Care. 2004 Dec;10(6):476-82
references: 15616389
references: Am J Surg. 2004 Dec;188(6):801-6
references: 15619503
references: Am J Physiol. 1957 Sep;190(3):513-6
references: 13470084
references: Nephrol Dial Transplant. 2009 Jul;24(7):2179-86
references: 19218540
references: Burns Incl Therm Inj. 1988 Apr;14(2):107-12
references: 3292014
references: Arch Intern Med. 1995 Jul 24;155(14):1505-11
references: 7605152
references: South Med J. 1991 Jun;84(6):692-6
references: 2052955
references: J Am Coll Cardiol. 2005 Jan 18;45(2):268-71
references: 15653026
references: Lancet. 1986 Aug 23;2(8504):456
references: 2874434
references: J Emerg Med. 1999 Sep-Oct;17(5):783-9
references: 10499690
references: J Trauma. 1994 May;36(5):685-90
references: 8189471
references: J Am Soc Nephrol. 2005 Dec;16(12):3721-7
references: 16236809
references: Burns. 1997 Mar;23(2):160-5
references: 9177886
references: Am J Med. 1984 Oct;77(4):699-702
references: 6486145
references: Nephrol Dial Transplant. 2007 Jan;22(1):285
references: 16880180
references: Crit Care Med. 2005 Feb;33(2):315-22
references: 15699833
references: Med Intensiva. 2006 Nov;30(8):363-9
references: 17129533
references: J Burn Care Rehabil. 1998 Jul-Aug;19(4):346-8
references: 9710734
references: Scand J Plast Reconstr Surg. 1979;13(1):189-92
references: 451471
references: Burns. 2010 Mar;36(2):205-11
references: 19836141
references: Nephrol Dial Transplant. 2008 May;23(5):1569-74
references: 18281319
references: Circ Shock. 1982;9(5):529-41
references: 6184182
references: Ann Burns Fire Disasters. 2012 Mar 31;25(1):26-37
references: 23012613
references: Ann Surg. 2007 Apr;245(4):622-8
references: 17414612
references: Am J Respir Crit Care Med. 2010 May 15;181(10):1128-55
references: 20460549
references: Am J Surg. 1995 Dec;170(6):696-9; discussion 699-700
references: 7492029
references: J Trauma. 2004 Feb;56(2):404-13; discussion 413-4
references: 14960986
references: Crit Care Med. 1996 Nov;24(11):1849-57
references: 8917036
references: Burns. 2002 Mar;28(2):167-72
references: 11900941
references: J Clin Invest. 2002 Jul;110(1):101-8
references: 12093893
references: Kidney Int Suppl. 1998 May;66:S16-24
references: 9580541
references: N Engl J Med. 2009 Oct 22;361(17):1627-38
references: 19846848
references: Arch Intern Med. 1982 Nov;142(12):2087-91
references: 7138158
references: J Trauma. 2008 Feb;64(2 Suppl):S179-85; discussion S185-7
references: 18376163
references: Crit Care Med. 2008 Feb;36(2):610-7
references: 18216610
references: Arch Intern Med. 1985 Jan;145(1):108-12
references: 3970621
references: Arch Surg. 1980 Apr;115(4):439-43
references: 7362451
references: Semin Dial. 2001 May-Jun;14(3):233-4
references: 11422936
references: J Burn Care Res. 2010 Jan-Feb;31(1):83-92
references: 20061841
references: Scand J Plast Reconstr Surg. 1979;13(1):9-16
references: 221969
references: JAMA. 1995 Jan 11;273(2):117-23
references: 7799491
references: J Trauma. 1994 Feb;36(2):168-72
references: 8114129
references: Arch Surg. 1998 Jul;133(7):752-6
references: 9688004
references: Nephrol Dial Transplant. 2012 Mar;27(3):956-61
references: 21856761
references: Resuscitation. 2007 Mar;72(3):371-8
references: 17137702
references: Crit Care. 2008;12(3):R74
references: 18533029
references: J Am Soc Nephrol. 2006 Jan;17(1):254-61
references: 16267155
references: J Am Soc Nephrol. 2005 Nov;16(11):3365-70
references: 16177006
references: Crit Care. 2009;13(3):R62
references: 19409089
references: J Clin Invest. 2003 Aug;112(4):460-7
references: 12925683
references: Adv Chronic Kidney Dis. 2013 Jan;20(1):76-84
references: 23265599
references: Ann Intern Med. 2009 May 5;150(9):604-12
references: 19414839
references: Am J Kidney Dis. 2007 Apr;49(4):517-23
references: 17386319
references: Kidney Int. 1998 Dec;54(6):1817-31
references: 9853246
references: Arch Int Pharmacodyn Ther. 1973 Aug;204(2):228-41
references: 4748776
references: Arch Intern Med. 2005 Dec 12-26;165(22):2666-70
references: 16344426
references: N Engl J Med. 2005 May 19;352(20):2049-60
references: 15901858
references: J Trauma. 2005 May;58(5):1011-8
references: 15920417
references: Clin Plast Surg. 1974 Oct;1(4):693-703
references: 4609676
references: Am J Nephrol. 2003 Jan-Feb;23(1):55-60
references: 12373081
references: J Burn Care Res. 2007 Mar-Apr;28(2):231-40
references: 17351438
references: Curr Opin Crit Care. 2004 Dec;10(6):468-75
references: 15616388
references: Am J Kidney Dis. 2008 Mar;51(3):395-406
references: 18295055
references: J Am Soc Nephrol. 2008 Jun;19(6):1233-8
references: 18337480
references: N Engl J Med. 2004 Jul 8;351(2):159-69
references: 15247356
references: Br J Pharmacol. 1995 Dec;116(8):3309-15
references: 8719812
references: Crit Care Med. 2004 Mar;32(3):858-73
references: 15090974
references: Am J Surg. 1985 Dec;150(6):716-20
references: 4073365
references: J Burn Care Rehabil. 1997 Mar-Apr;18(2):109-15
references: 9095419
references: Curr Opin Crit Care. 2002 Dec;8(6):509-14
references: 12454534
references: J Surg Res. 1981 Mar;30(3):249-55
references: 7230773
references: J Trauma. 1988 Aug;28(8):1181-7
references: 2970556
references: Crit Care. 2008;12(5):R124
references: 18847465
references: Burns. 1997 Aug;23(5):446-50
references: 9426917
references: J Surg Res. 1976 May;20(5):401-4
references: 933497
references: J Burn Care Rehabil. 2003 Mar-Apr;24(2):75-84
references: 12626925
references: Kidney Int. 1985 Jun;27(6):928-37
references: 4021321
references: Crit Care. 2004 Aug;8(4):R204-12
references: 15312219
references: Kidney Int. 1998 Aug;54(2):554-60
references: 9690223
references: J Am Soc Nephrol. 2006 Oct;17(10):2892-9
references: 16959827
references: J Crit Care. 1995 Mar;10(1):27-32
references: 7757140
references: Kidney Int. 2002 Dec;62(6):2223-9
references: 12427149
references: Am J Med. 1962 Jan;32:65-79
references: 13887292
references: J Trauma. 1986 Jul;26(7):638-42
references: 3723639
references: J Burn Care Res. 2007 May-Jun;28(3):382-95
references: 17438489
references: Arch Intern Med. 1980 Jul;140(7):907-9
references: 7387298
references: J Trauma. 1978 Sep;18(9):664-6
references: 731756
references: Am J Kidney Dis. 2009 Jun;53(6):961-73
references: 19346042
references: Best Pract Res Clin Anaesthesiol. 2004 Mar;18(1):1-20
references: 14760871
references: Crit Care Med. 2000 Jan;28(1):163-71
references: 10667517
references: Ann Intern Med. 2005 Apr 5;142(7):497-505
references: 15809461
references: Ann Surg. 2008 Sep;248(3):387-401
references: 18791359
references: Circulation. 1997 Feb 18;95(4):778-81
references: 9054727
references: Crit Care Med. 2005 Nov;33(11):2494-500
references: 16276172
references: Nat Med. 1999 Jul;5(7):788-92
references: 10395324
references: Crit Care Med. 2002 May;30(5 Suppl):S302-12
references: 12004252
references: Kidney Int. 2009 Aug;76(4):422-7
references: 19436332
references: FASEB J. 2002 Oct;16(12):1567-74
references: 12374779
references: Br J Surg. 1967 Feb;54(2):132-41
references: 6016765
references: Ann Surg. 1997 May;225(5):554-65; discussion 565-9
references: 9193183
references: J Trauma. 2000 Sep;49(3):387-91
references: 11003313
references: Burns Incl Therm Inj. 1985 Jun;11(5):367-70
references: 4027751
references: J Natl Cancer Inst. 1989 Jan 4;81(1):59-63
references: 2783257