Kidney injury: A serious risk to the health and survival of today's soldiers

Acute kidney injury (AKI), an abrupt or rapid decline in kidney function, is a serious and increasingly prevalent condition. Little information has been available about how common or how severe AKI is in military personnel who are injured during combat in Iraq and Afghanistan. A new study appearing in an upcoming issue of the Clinical Journal of the American Society Nephrology (CJASN) investigates this question in those burned during combat.

Captain Ian Stewart, MD, USAF (San Antonio Military Medical Center, Fort Sam Houston) and his colleagues examined military casualties who were evacuated from Iraq and Afghanistan to burn units. When they used two different classification systems for AKI, the researchers found that AKI prevalence rates were 23.8% (according to one system) and 29.9% (according to the other) among 692 evacuated casualties. Patients with AKI were much more likely to die than patients without AKI: the among patients with moderate and severe AKI were 21.4% to 33.3% and 62.5% to 65.1%, respectively, compared with 0.2% among patients without AKI.

The majority of patients (57.6%) were diagnosed with AKI when they were admitted to the hospital, implying that factors related to combat may be responsible. Conversely, for patients who developed AKI after the first week (17.6%), complications from their hospitalization were likely the cause. Patients in the intermediate time range (24.8%) probably had some combination of factors.

"Our research shows that if a wounded warrior develops , he or she is at an increased risk of dying," said Dr. Stewart. "By preventing or modifying kidney injury, we may be able to improve survival in military personnel with burns and/or other ," he added. Additional studies are needed to test whether intervening to reduce AKI will save lives.

add to favorites email to friend print save as pdf

Related Stories

Kidney injury in hospital increases long-term risk of death

Dec 17, 2009

Patients with sudden loss of kidney function, called acute kidney injury (AKI), are more likely to die prematurely after leaving the hospital—even if their kidney function has apparently recovered, according to an upcoming ...

Recommended for you

Study: Americans endure unwanted care near death

10 hours ago

Americans suffer needless discomfort and undergo unwanted and costly care as they die, in part because of a medical system ruled by "perverse incentives" for aggressive care and not enough conversation about what people want, ...

Failed Medicare payments law remains relevant

10 hours ago

In a new commentary in the journal JAMA Surgery, Dr. Eli Adashi recounts what he and other advocates saw as merits of the originally bipartisan Sustainable Growth Rate Repeal and Medicare Provider Paymen ...

User comments