Kidney disease improving global outcome for predicting acute kidney injury in traumatic brain injury patients

AbstractAimTo determine the incidence of acute kidney injury (AKI) based on Kidney Disease Improving Global Outcome (KDIGO) criteria in patients with severe traumatic brain injury and to study AKI in relation to risk factors and outcomes.MethodThis trial was a descriptive analytic study on 83 patients with severe traumatic brain injury admitted to Poursina Hospital (Rasht, Iran). The incidence of AKI was determined based on KDIGO criteria over a 12-month period. The correlation of mortality rates, multi-organ failure (MOF), and neurologic outcome to AKI were studied.ResultsOf 83 eligible patients who entered the study, 25.3% (N=21) developed AKI based on KDIGO criteria. Glasgow Outcome Scale on admission was the only risk factor significantly associated with the incidence of AKI (p=0.001). Mortality rates (62% vs. 22.6%, p=0.002) and the occurrence of MOF were significantly higher in patients who developed AKI (23.8% vs. 0% MOF based on Sequential Organ Failure Assessment, p<0.0001; 19% vs. 0% MOF based on Multiple Organ Dysfunction score, p<0.0001). Poor neurologic outcome was observed in 95% and 92% of patients with and without AKI, respectively (p=0.674).ConclusionThe incidence of AKI among patients with severe traumatic brain injury is striking. The association of Glasgow Outcome Scale with AKI helps to identify patients at a higher risk of developing AKI. Significant rates of mortality and MOF among patients with severe traumatic brain injury and AKI, necessitates consideration of renoprotective measures from the early days of hospital admission

Incidence of Hyperbilirubinemia and Urinary Tract Infection (UTI) in Asymptomatic Term Neonates Under Two Weeks of Age

Background: Hyperbilirubinemia is a common cause of referral to neonatal care units. According to several studies, jaundice is among the primary symptoms of urinary tract infection (UTI) in neonates. This study aimed to determine the prevalence of UTI in asymptomatic term neonates diagnosed with indirect hyperbilirubinemia within the first two weeks of birth. Methods: This prospective study was conducted on 314 term neonates under 14 days of age, presented with unexplained indirect hyperbilirubinemia for UTI (total bilirubin level: 15 mg/dl). Subjects were referred to 17-Shahrivar Children’s Hospital in Rasht during 16 months, and neonates diagnosed with UTI were further investigated. Results: Out of 314 neonates, 12 patients (3.8%) were diagnosed with UTI, and E. coli was the most prevalent pathogen in these patients. No significant differences were observed between neonates with and without UTI in terms of gender, birth weight, age, bilirubin level on admission and mode of delivery (P>0.05). Additionally, pyuria and bacteriuria were significantly more prevalent among UTI patients compared to other neonates (