Urinary pH as a prognosticator of acute kidney injury in crush syndrome

Abstract

Background: Crush syndrome arises from community assault when perpetrators of crime within a community are beaten resulting in muscle damage of varying degrees. The insult to the muscles leads to the development of acute kidney injury which may lead to the need for renal replacement therapy, intensive care unit (ICU) admission for cardiovascular and respiratory support, or death. There are various known methods used to prognosticate patients with crush syndrome. The current literature only provides limited information about the role of urinary pH when it comes to risk stratifying patients with crush syndrome, thus the aim of the study is to reveal whether a urinary pH of 6 or less could potentially predict poor outcomes in those who present with this pathology.

Methods: This paper is a quantitative retrospective review of 107 patients who were diagnosed with myorenal syndrome at Ngwelezana Hospital between September 2021 and September 2023.

Results: Sixty out 107 patients developed an acute kidney injury and three patients died. All participants who died had a urine pH of < 6; however, patients who required dialysis or needed ICU admission had urine pH of 5 and 6 showing no correlation between urine pH and adverse outcomes.

Conclusions: Urine pH may not serve as a marker of complications related to acute kidney injury in patients with crush syndrome but may help to prognosticate patients to predict death.