Urine biochemistry in septic and non-septic acute kidney injury: a prospective observational study

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 coh...

Full description

Saved in:
Bibliographic Details
Published in:Journal of critical care 2013-08, Vol.28 (4), p.371-378
Main Authors: Bagshaw, Sean M., MD, MSc, Bennett, Michael, PhD, Devarajan, Prasad, MD, Bellomo, Rinaldo, MD
Format: Article
Language:English
Subjects:
Acute kidney injury
Acute Kidney Injury - mortality
Acute Kidney Injury - urine
Acute-Phase Proteins - urine
Aged
APACHE
Area Under Curve
Biochemistry
Biomarkers
Biomarkers - urine
Chi-Square Distribution
Critical Care
Critical Illness
Female
Fractional excretion of sodium
Fractional excretion of urea
Hospital Mortality
Hospitalization
Humans
Lipocalin-2
Lipocalins - blood
Lipocalins - urine
Logistic Models
Male
Middle Aged
Mortality
Neutrophil gelatinase-associated lipocalin
Observation
Prospective Studies
Proto-Oncogene Proteins - blood
Proto-Oncogene Proteins - urine
Renal replacement therapy
Sepsis
Sepsis - mortality
Sepsis - urine
Sodium - urine
Urea - urine
Urinalysis
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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 gelatinase-associated lipocalin (NGAL), worsening AKI, renal replacement therapy (RRT), and mortality. Results Eighty-three patients were enrolled, 43 (51.8%) with sepsis. RIFLE class was not different between groups ( P = .43). Urine sodium (UNa) < 20 mmol/L, fractional excretion of sodium (FeNa) < 1%, and fractional excretion of urea (FeU) < 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 NGAL was higher for FeNa≥1% compared to FeNa
ISSN:0883-9441
1557-8615
DOI:10.1016/j.jcrc.2012.10.007