Fractional excretion of urea as a diagnostic index in acute kidney injury in intensive care patients
Journal of Critical Care, 04/23/2012
Dewitte A et al. – Fractional excretion of urea less than 40% was found to be a sensitive and specific index in differentiating transient from persistent acute kidney injury (AKI) in intensive care unit patients especially if diuretics had been administered.
This was an observational study.
Forty-seven patients with AKI according to the RIFLE classification were included.
Transient AKI was defined as AKI resolved within 3days after inclusion.
Persistent AKI was defined as persistent serum creatinine elevation or oliguria.
Fractional excretion of urea was lower in case of transient, 33% (25-39), than persistent AKI, 47% (36-61) (P=.001).
Areas under the receiver operating characteristic curve for FeU in case of transient AKI were better than those for other urinary indexes, 0.78 (95% confidence interval, 0.63-0.92).
Optimal cutoff point according to the receiver operating characteristic curve was 40%.
In patients treated with diuretics, FeU was the only predictive index of transient AKI.
Fractional excretion of urea gradually increased from days 1 to 7 in transient AKI, whereas plasma creatinine decreased.
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