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Urine biochemistry in septic and non-septic acute kidney injury: a prospective observational study.
- Source :
- Journal of Critical Care; 2013, Vol. 28 Issue 4, p371-378, 8p
- Publication Year :
- 2013
-
Abstract
- Purpose: Determine whether there are unique patterns to the urine biochemistry profile in septic compared with non-septic acute kidney injury (AKI) and whether urinary biochemistry predicts worsening AKI, need for renal replacement therapy and mortality. Materials and Methods: Prospective cohort study of critically ill patients with septic and non-septic AKI, defined by the RIFLE (Risk, Injury, Failure, Loss, End-Stage) criteria. Urine biochemistry parameters were compared between septic and non-septic AKI and were correlated with neutrophil gelatinaseassociated lipocalin (NGAL), worsening AKI, renal replacement therapy (RRT), and mortality. Results: Eighty-three patients were enrolled, 43 (51.8%) with sepsis. RIFLE classwas not different between groups (P = .43). Urine sodium (UNa) b 20 mmol/L, fractional excretion of sodium (FeNa) b1%, and fractional excretion of urea (FeU) b 35% were observed in 25.3%, 57.8%, and 33.7%, respectively. Septic AKI had lower UNa compared with non-septic AKI (P = .04). There were no differences in FeNa or FeU between groups. Urine NGALwas higher for FeNa.1%compared to FeNab1%(177.4 ng/mL [31.9-956.5] vs 48.0 ng/mL [21.1-232.4], P = .04). FeNa showed low correlation with urine NGAL (P = .05) and plasma NGAL (P = .14). There was poor correlation between FeU and urine NGAL (P =.70) or plasmaNGAL (P = .41). UNa, FeNa, and FeU showed poor discrimination for worsening AKI, RRT and mortality. Conclusion: Urine biochemical profiles do not discriminate septic and non-septicAKI. UNa, FeNa, and FeU do not reliably predict biomarker release, worsening AKI, RRT ormortality. These data imply limited utility for these measures in clinical practice in critically ill patients with AKI. [ABSTRACT FROM AUTHOR]
- Subjects :
- KIDNEY disease diagnosis
KIDNEY disease risk factors
SEPSIS
URINE
ACADEMIC medical centers
APACHE (Disease classification system)
ARTIFICIAL respiration
BIOCHEMISTRY
CRITICAL care medicine
CRITICALLY ill
EPIDEMIOLOGY
EVALUATION of medical care
MEDICAL needs assessment
NEUTROPHILS
PATIENTS
PHYSIOLOGY
DIAGNOSIS
Subjects
Details
- Language :
- English
- ISSN :
- 08839441
- Volume :
- 28
- Issue :
- 4
- Database :
- Supplemental Index
- Journal :
- Journal of Critical Care
- Publication Type :
- Academic Journal
- Accession number :
- 89299064
- Full Text :
- https://doi.org/10.1016/j.jcrc.2012.10.007