Table 1.
Demographics and characteristics of wounded warriors requiring RRT for AKI managed in the National Capital Region (n=51)
| Characteristic | Value |
|---|---|
| Demographic features | |
| Age at injury (y) | 26±6 |
| Sex, male:female | 50:1 |
| Race | |
| White | 34 (67) |
| Black | 8 (16) |
| Other | 9 (18) |
| Injury features | |
| Type of injury | |
| IED | 35 (69) |
| GSW | 6 (12) |
| Rocket/RPG/mortar | 4 (8) |
| Poisoning | 3 (6) |
| Immobilization trauma | 2 (4) |
| Cardiac arrest/shock | 1 (2) |
| Rhabdomyolysis | 2 (4) |
| Postconcussive seizures | 1 (2) |
| Physical assault/ingestion | 1 (2) |
| Vehicular | 1 (2) |
| Units of PRBCs downrange (n=47) | 24 (0–200) |
| Estimated surgeries until death or discharge | 10 (0–36) |
| Amputation | 36 (71) |
| Maximum CPK (n=49) (units/L) | 14,550 (155–1,900,000) |
| Urinary tract trauma/injurya | 24 (47) |
| Kidney(s) | 5 (20) |
| Ureter(s) | 5 (20) |
| Bladder | 12 (50) |
| Urethra | 14 (58) |
| Total hospital days in National Capital Region | 51 (6–312) |
| Clinical features of AKI | |
| Presumed Cause of AKIb | |
| ATN | 50 (98) |
| Sepsis/hypotension | 46 (92) |
| Rhabdomyolysis | 36 (72) |
| IV contrast | 3 (6) |
| Cortical necrosis (by biopsy) | 1 |
| 60-d mortality | 11 (22) |
| Death on RRT | 8 (16) |
| Days from injury to RRT | 4 (1–66) |
| Dialysis initiated before reaching CONUS | 30 (59) |
| Serum creatinine at initiation (n=49) (mg/dl) | 5.58±2.85 |
| AKI integer score (n=49) | 22 (14–37) |
| Probability of death from AKI integer score (%) | 33 (6–96) |
| ESRD | 1 (2) |
| Indications for dialysisc | |
| Hyperkalemia | 35 (69) |
| Volume overload | 25 (49) |
| Acidosis | 23 (45) |
| Azotemia | 26 (51) |
| Other | 2 (4) |
| Days on RRT to death or recovery (n=50) | 17 (1–51) |
| RRT treatments per week | 5.0±1.4 |
| RRT modalities: 31 (61%) were treated with >1 modality | |
| iHD | 50 (98) |
| SLEDD | 25 (49) |
| CRRT | 13 (26) |
| PD | 0 (0) |
| Serum creatinine at hospital discharge (n=40) (mg/dl) | 1.03±1.51 |
| On dialysis at hospital discharge (n=40) | 1 (2.5) |
Data are presented as mean±SD, median (range), or count (%). IED, improvised explosive device; GSW, gunshot wound; RPG, rocket-propelled grenade; PRBCs, packed red blood cells; CPK, creatine phosphokinase; IV, intravenous; CONUS, continental United States; iHD, intermittent hemodialysis; SLEDD, slow low efficiency daily dialysis; CRRT, continuous RRT; PD, peritoneal dialysis.
a
Individual patients could have more than one site of urologic injury.
b
Individual patients with clinical acute tubular necrosis could be assigned more than one potential etiology.
c
Individual patients could have more than one indication for RRT.