Effect of mannitol plus hypertonic saline combination versus hypertonic saline monotherapy on acute kidney injury after traumatic brain injury

Purpose: To compare the effect of mannitol plus hypertonic saline combination (MHS) versus hypertonic saline monotherapy (HS) on renal function in patients with traumatic brain injury (TBI). Materials and methods: This was a secondary analysis of data from the Resuscitation Outcomes Consortium Hypertonic Saline Trial Shock Study and Traumatic Brain Injury Study. The study cohort included a propensity matched subset of patientswith TBIwho receivedMHS or HS. The primary outcome measurewas themaximum serum creatinine value during critical illness. Results: The cohort consisted of 163 patients in the MHS group and 163 patients in the HS group (n = 326). The maximum serum creatinine value during hospitalization was 82 +/- 47 mu mol/L (0.86 +/- 0.26 mg/dL) in the MHS group and 76 +/- 23 mu mol/L (0.92 +/- 0.53 mg/dL) in the HS group (difference -6 mu mol/L, 95% CI -14 to 2 mu mol/L, p =.151). The lowest eGFR during hospitalization was 108 +/- 25 mL/ min in the MHS group and 112 +/- 24 mL/min in the HS group (difference -4 mL/min, 95% CI -1 to 9 mLmin, p =.150). Conclusions: The addition ofmannitol toHS did not increase the risk of renal dysfunction compared to HS alone in patients with TBI. (c) 2020 Elsevier Inc. All rights reserved.