Kidney failure trajectories and sub phenotypes in severe burn patients
Authors' conclusion
Primary AKI represents the most severe renal complication post-burn, while secondary injuries reflect later complications such as infection, hemorrhagic complications, or ARDS.
Study context
- Population
- Adult (>18 years) ICU burn patients with total burn surface area >15%, 2013–2023
- Participants
- 733 participants
- Exposure
- Primary acute kidney injury (AKI) vs Secondary AKI alone vs acute kidney disease (AKD) alone vs Both
- Primary AKIn = 158
- Outcome
- Renal injury phenotypes
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
- Primary AKI
- 158 (21.6%)
- Mortality in primary AKI
- 95/158 (60.1%)
- Further renal injury among 121 primary AKI survivors
- 58 (45.7%)
- Secondary AKI alone
- 16.5%
- AKD alone
- 10.7%
- Both secondary AKI and AKD
- 20.7%
Observational data: associations, not effects.
Further findings
Mortality with secondary AKI and AKD
- Secondary AKI mortality
- 39%
- AKD mortality
- 41%
- Secondary AKI and AKD independently linked to increased mortality
Predictors of phenotypes
- Primary AKI driven by baseline vulnerability and burn severity; strongest associations dementia, hydroxocobalamin treatment, smoke inhalation
- Secondary AKI and AKD characterised by ICU complications; infection the dominant predictor
Original publication
Kidney failure trajectories and sub phenotypes in severe burn patients. Anaesth Crit Care Pain Med. Published 14 November 2025. doi:10.
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