Impact of Acute Kidney Injury on the Critical Patient with Brain Injury

• Grant number: 23/14137-0
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: December 01, 2023
• End date: November 30, 2024
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Lucia da Conceição Andrade
• Grantee: João Pedro Miranda Vieira Farias
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

Traumatic brain injury (TBI) is a significant public health challenge, characterized by a series of complex pathophysiological processes that occur following the initial injury. Acute kidney injury (AKI) emerges as a significant exacerbating factor, due to its potential impact on cerebral edema and the overall prognosis of TBI patients. Although the majority of AKI episodes associated with TBI are of a mild nature, literature suggests that only 2% of cases require dialysis treatment. Surprisingly, even in mild cases, there is an increased risk of mortality and severity of neurological sequelae. The etiology of AKI in TBI is multifactorial, involving excessive release of catecholamines, systemic inflammation, comorbidities, use of medications for intracranial pressure control, hypovolemia, rhabdomyolysis, among other factors. Additionally, determining the true incidence of AKI in TBI is challenging due to variations in validation criteria used in previous studies. This study aims to analyze the incidence of acute kidney injury in patients with TBI, including isolated and non-isolated cases, using criteria established by KDIGO. Furthermore, we seek to assess the impact of this complication on mortality and neurological sequelae, as well as identify risk factors associated with this condition.