Urinalysis and pre-renal acute kidney injury: time to move on.

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State: Public
Version: author
Serval ID
serval:BIB_A3EDB1DF3D16
Type
Article: article from journal or magazin.
Publication sub-type
Editorial
Collection
Publications
Institution
Title
Urinalysis and pre-renal acute kidney injury: time to move on.
Journal
Critical Care
Author(s)
Schneider A.G., Bellomo R.
ISSN
1466-609X (Electronic)
ISSN-L
1364-8535
Publication state
Published
Issued date
2013
Volume
17
Number
3
Pages
141
Language
english
Notes
pdf: Commentary
Abstract
Urinary indices are classically believed to allow differentiation of transient (or pre-renal) acute kidney injury (AKI) from persistent (or acute tubular necrosis) AKI. However, the data validating urinalysis in critically ill patients are weak. In the previous issue of Critical Care, Pons and colleagues demonstrate in a multicenter observational study that sodium and urea excretion fractions as well as urinary over plasma ratios performed poorly as diagnostic tests to separate such entities. This study confirms the limited diagnostic and prognostic ability of urine testing. Together with other studies, this study raises more fundamental questions about the value, meaning and pathophysiologic validity of the pre-renal AKI paradigm and suggests that AKI (like all other forms of organ injury) is a continuum of injury that cannot be neatly divided into functional (pre-renal or transient) or structural (acute tubular necrosis or persistent).
Pubmed
Web of science
Open Access
Yes
Create date
07/02/2014 21:07
Last modification date
20/08/2019 15:09
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