Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
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Nephrol. Dial. Transplant. · Feb 2011
Defining urine output criterion for acute kidney injury in critically ill patients.
The widespread use of RIFLE and AKIN classification systems for acute kidney injury (AKI) diagnosis and staging has established the association between AKI severity and adverse outcomes. However, as a result of the difficulties in measuring and recording the urine output every hour, a few prospective studies have validated the urine output criterion as stated in these classification systems. We assessed hourly urine output in ICU patients using an automated and accurate device to determine if changes in urine flow and volume could be a sensitive marker of AKI. Additionally, we assessed various definitions of oliguria to determine whether measurement of urine output using a fixed 6-h interval that matches nurses' shifts would be equivalent to the current standard for AKI diagnosis and staging. ⋯ Episodes of oliguria occur frequently in ICU patients and identify a higher percentage of AKI patients compared to serum creatinine criterion. Alterations in urine flow may be a sensitive marker of renal dysfunction and need to be validated in larger cohorts.
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Nephrol. Dial. Transplant. · Feb 2011
Osteopontin predicts survival in critically ill patients with acute kidney injury.
The cytokine osteopontin is involved in the pathophysiology of experimental acute kidney injury. We have tested the hypothesis that osteopontin levels might serve as a biomarker predicting outcome in critically ill patients requiring renal replacement therapy after acute kidney injury. ⋯ Osteopontin may serve as a novel biomarker for both, overall survival and renal outcome in critically ill patients with acute kidney injury, that require renal replacement therapy.
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Nephrol. Dial. Transplant. · Feb 2011
Application of the RIFLE criteria in patients with crush-related acute kidney injury after mass disasters.
The term acute kidney injury (AKI) and its classification in strata defined as Risk, Injury, Failure, Loss and End-stage renal failure (RIFLE) need to be validated in different patient groups. RIFLE may be useful to foresee medical and logistic problems in crush-related AKI in disaster victims. ⋯ In disaster crush victims, RIFLE classification can be useful to foresee the medical complications, need for therapeutic interventions and logistic support and also renal function at discharge though, perhaps, not survival.
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Nephrol. Dial. Transplant. · Jan 2011
Comparative StudyChronic kidney disease and 1-year survival in elderly patients discharged from acute care hospitals: a comparison of three glomerular filtration rate equations.
Glomerular filtration rate (GFR) is directly associated with survival. However, the prognostic significance of GFR might be different according to the formula used to estimate it. We aimed at comparing the association between GFR estimated using three different formulas and 1-year survival in elderly patients discharged from acute care hospitals. ⋯ GFR adds to the list of prognostic indicators in elderly and frail people, and CKD-EPI-derived GFR, which outperforms to some extent MDRD and CG-BSA-derived GFR in a multivariable predictive model, seems worthy of testing in wider populations.