Vol 17: Urinary output and fractional excretion of sodium and urea as indicators of transient versus intrinsic acute kidney injury during early sepsis.Reportar como inadecuado



 Vol 17: Urinary output and fractional excretion of sodium and urea as indicators of transient versus intrinsic acute kidney injury during early sepsis.


Vol 17: Urinary output and fractional excretion of sodium and urea as indicators of transient versus intrinsic acute kidney injury during early sepsis. - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Descargar gratis o leer online en formato PDF el libro: Vol 17: Urinary output and fractional excretion of sodium and urea as indicators of transient versus intrinsic acute kidney injury during early sepsis.
This article is from Critical Care, volume 17.AbstractIntroduction: The pathophysiology of acute kidney injury AKI in sepsis is ill defined. We investigated parameters associated with low glomerular filtration, and their predictive value to discriminate transient from intrinsic septic AKI. Methods: In 107 sepsis patients, AKI was defined by the Risk, Injury, Failure, Loss of Kidney Function, End-stage renal disease RIFLE urinary output or serum creatinine criterion, or both. Transient AKI TAKI versus intrinsic AKI was defined as RIFLE R, I, or F on the first day evolving to no AKI or not, respectively, over the following 5 days. Fractional excretion of sodium FENa, urea FEUrea, and NGAL FENGAL at admission d0t0, 4 d0t4, and 24 hours d1 was determined. Results: Including versus not including the urinary-output criterion of RIFLE increased AKI from 43% to 64.5%. Median uNGAL levels and FENGAL were lower in no AKI versus transient AKI when AKI was defined based on creatinine P = 0.002 and P = 0.04, respectively, but not when based on urinary output P = 0.9 and P = 0.49, respectively. FENa 1% and FEUrea 0.36% and FEUrea 31.5% was 92% and 94.5% respectively. Conclusions: A low FENa and FEUrea is highly prevalent in the first hours of sepsis. In sepsis, oliguria is an earlier sign of impending AKI than increase in serum creatinine. A combination of a high FENa and a low FEUrea is associated with intrinsic AKI, whereas a combined high FENa and FEUrea is strongly predictive of transient AKI.



Autor: Vanmassenhove, Jill; Glorieux, Griet; Hoste, Eric; Dhondt, Annemieke; Vanholder, Raymond; Van Biesen, Wim

Fuente: https://archive.org/



DESCARGAR PDF




Documentos relacionados