Acute Kidney Injury in Poly Trauma Patients

Trauma causes significant morbidity and mortality in all age groups but particularly for those below 60 years and is one of the top 5 causes of death (1,2).Most deaths occur in adults who are between 15 and 44 years(3).Polytrauma originates from the Greek words poly which means multiple and trauma which means wounds. The term polytrauma, which was defined using the new Berlin definition, as cases with an Abbreviated Injury Scale (AIS)≥3 for two or more different body regions and one or more additional variables from five physiologic parameters (hypotension[systolic blood pressure≤90 mmHg], unconsciousness[Glasgow Coma Scale score≤8], acidosis [base excess≤ -6.0], coagulopathy [partial thromboplastin time≥40 s or international normalized ratio≥1.4], and age [≥70 years]) [4].There are complex pathophysiological changes that happen in a polyrauma patient which requires effective treatment for improving morbidity and mortality outcomes. Hemorrhage, systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS) are some of the complications of trauma whose effects are not only local but also systemic. There are mechanisms and triggers which result in cardio-vascular shock, hemostasis, apoptosis, organ dysfunctions and immune suppression (CHAOS) [5]. These local and systemic pathophysiological changes that occur in polytrauma (CHAOS) eventually lead to Acute Kidney Injury (AKI) which further worsens their outcomes [6,7].