2019 Volume 1 Issue 2 Pages 69-75
BACKGROUND
Previous studies have suggested that haptoglobin may be beneficial for preventing acute kidney injury (AKI) after severe burns. Although haptoglobin has been approved for the treatment of haemoglobinuria and subsequent AKI in Japan, robust evidence for this is lacking. We examined whether haptoglobin may be effective in preventing AKI requiring renal replacement therapy among patients with severe burns.
METHODS
We performed propensity score-matched analyses of the Japanese nationwide Diagnosis Procedure Combination inpatient database. We identified patients with severe burns (burn index ≥ 10) whose data were recorded from 1 July 2010 to 31 March 2013. We compared patients who were administered haptoglobin within 2 days of admission (haptoglobin group) and those who were not administered haptoglobin (control group). The main outcomes were: requirement for renal replacement therapy during admission, 28-day in-hospital mortality, length of hospital stay and ventilator-free days.
RESULTS
Eligible patients (n = 3223) from 618 hospitals were categorized into either the haptoglobin group (n = 263) or the control group (n = 2960). Propensity score matching created a matched cohort of 185 pairs with and without haptoglobin. There were no significant differences between the propensity score-matched groups in terms of the proportion of patients requiring renal replacement therapy (control vs haptoglobin, 25.9% vs 31.9%; p = 0.25), ventilator-free days (13 vs 6 days, p = 0.95), length of hospital stay (38 vs. 27, p = 0.45) and 28-day mortality (42.7% vs 46.5%, p = 0.53).
CONCLUSIONS
Our results suggest that haptoglobin use is not associated with reduced requirement for renal replacement therapy, increased ventilator-free days, length of hospital stay, or reduced 28-day mortality in patients with severe burns.
