Oliguria and Biomarkers of Acute Kidney Injury: Star Struck Lovers or Strangers in the Night?

Lehner, Georg; Forni, Lui G.; Joannidis, Michael

doi:10.1159/000447979

Cited by 25 publications

(18 citation statements)

References 43 publications

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“…Therefore, the presence of oliguria may be misleading in that it may reflect a normal physiological response or may be indicative of transient haemodynamic disturbance and not necessarily indicative of significant tubular injury. Indeed, severe tubular injury may not be apparent initially as oliguria given that conhttp://epublishing.ekt.gr | e-Publisher: EKT | Downloaded at 29/08/2020 10:53:47 | flow reflects GFR and oliguria will not be apparent until GFR has fallen significantly [7]. The KDIGO criteria for AKI are based on the presence of oliguria for a minimum 6h [2].…”

Section: Urine Output Limitationsmentioning

confidence: 99%

Biomarkers of acute kidney injury in a mixed ICU population. a narrative review

Nanas

Nanas²,

Kokkoris³

2019

HealthResJ

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Introduction: Acute kidney injury is a severe complication occurring in critically ill patients treated in the intensive care units, which has a significant impact on morbidity and mortality in these patients. Moreover, despite technological and pharmaceutical advances during the last decades, acute kidney injury is still associated with markedly increased morbidity and mortality. Creatinine, the most common renal dysfunction biomarker in use, has poor predictive accuracy for renal injury due to time delay in its increase and the influence by other factors on its serum concentration such as age, gender, muscle mass etc. Therefore, the need for better renal biomarkers in order to early detect and intervene for acute kidney injury prevention is imperative. During the last years several new acute kidney injury biomarkers have been discovered and validated to improve early detection of patients in risk groups for progressive renal failure, need for renal replacement therapy or death. Aim: The purpose of the present article is to review the studies that have tested the predictive ability of those biomarkers (in urine and/or plasma) for early detection of acute kidney injury in the mixed adult intensive care unit population. Material and Method: We searched Medline (PubMed) using the keywords: acute kidney injury, biomarkers, renal failure, ICU.Results: The most relevant articles were included in this review.Conclusions: During the past decade, multiple AKI biomarkers have been studied and viewed as promising. Further studies are needed to determine their clinical utility.

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Section: Urine Output Limitationsmentioning

confidence: 99%

Biomarkers of acute kidney injury in a mixed ICU population. a narrative review

Nanas

Nanas²,

Kokkoris³

2019

HealthResJ

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“…The definition of AKI is based on oliguria and elevated serum creatinine levels, two functional markers that are notoriously imperfect [1,2]. Oliguria is neither sensitive nor specific [1,3]. It can occur as result of renal injury but may also simply reflect an adaptive physiological response to both intracellular dehydration and hypovolemia [1].…”

Section: Predicting Akimentioning

confidence: 99%

Predictions are difficult…especially about AKI

2017

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“…Hypovolaemia is accepted as a major risk factor for the development of acute kidney injury (AKI) [1] and is associated with low urinary output [2]. Moreover, oliguria often occurs as the first clinical sign of AKI [3] and is one of the two criteria defining AKI according to the KDIGO guidelines [4].…”

Section: Introductionmentioning

confidence: 99%

Fluid management in acute kidney injury

et al. 2017

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Acute kidney injury (AKI) and fluids are closely linked through oliguria, which is a marker of the former and a trigger for administration of the latter. Recent progress in this field has challenged the physiological and clinical rational of using oliguria as a trigger for the administration of fluid and brought attention to the delicate balance between benefits and harms of different aspects of fluid management in critically ill patients, in particular those with AKI. This narrative review addresses various aspects of fluid management in AKI outlining physiological aspects, the effects of crystalloids and colloids on kidney function and the effect of various resuscitation and de-resuscitation strategies on the course and outcome of AKI.

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Oliguria and Biomarkers of Acute Kidney Injury: Star Struck Lovers or Strangers in the Night?

Cited by 25 publications

References 43 publications

Biomarkers of acute kidney injury in a mixed ICU population. a narrative review

Biomarkers of acute kidney injury in a mixed ICU population. a narrative review

Predictions are difficult…especially about AKI

Fluid management in acute kidney injury

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