Transient versus persistent acute kidney injury and the diagnostic performance of fractional excretion of urea in critically ill patients.

Nephron Clinical Practice Pub Date : 2014-01-01 Epub Date: 2014-01-11 DOI:10.1159/000357678

K A Wlodzimirow, A Abu-Hanna, A A N M Royakkers, P E Spronk, L S Hofstra, M A Kuiper, M J Schultz, C S C Bouman

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引用次数: 18

Abstract

Aims: To evaluate the performance of fractional excretion of urea (FeU) for differentiating transient (T) from persistent (P) acute kidney injury (AKI) and to assess performance of FeU in predicting AKI in patients admitted to the ICU.

Methods: We performed secondary analysis of a multicenter prospective observational cohort study on the predictive performance of biological markers for AKI in critically ill patients. AKI was diagnosed according to RIFLE staging.

Results: Of 150 patients, 51 and 41 patients were classified as having T-AKI and P-AKI, respectively. The diagnostic performance for FeU to discriminate T-AKI from P-AKI on the day of AKI was poor (AUC-ROC = 0.61; 95% CI: 0.49-0.73). The diagnostic performance of FeU to predict AKI 1 and 2 days prior to AKI was poor as well (AUC-ROC = 0.61; 95% CI: 0.47-0.74, and 0.58; 95% CI: 0.43-0.73, respectively).

Conclusions: FeU does not seem to be helpful in differentiating T- from P-AKI in critically ill patients and it is a poor predictor of AKI.

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危重病人短暂性与持续性急性肾损伤及尿素排泄分数的诊断价值

目的:评估尿素分数排泄(FeU)在鉴别短暂性(T)和持续性(P)急性肾损伤(AKI)中的表现，并评估FeU在预测ICU住院患者AKI中的表现。方法:我们对一项多中心前瞻性观察队列研究进行了二次分析，研究生物标志物对危重患者AKI的预测作用。根据RIFLE分期诊断AKI。结果:150例患者中，分别有51例和41例分为T-AKI和P-AKI。在AKI当天，FeU区分t型AKI和p型AKI的诊断性能较差(AUC-ROC = 0.61;95% ci: 0.49-0.73)。FeU在AKI前1天和2天预测AKI的诊断性能也很差(AUC-ROC = 0.61;95% CI: 0.47-0.74和0.58;95% CI分别为0.43-0.73)。结论:在危重患者中，FeU似乎不能帮助区分T- AKI和P-AKI，它是AKI的一个较差的预测指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nephron Clinical Practice 医学-泌尿学与肾脏学

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6-12 weeks