Relationship between nitrogen loss and blood urea nitrogen concentrations in patients requiring continuous renal replacement therapy

Sato, Takeaki; Kushimoto, Shigeki

doi:10.1002/ams2.219

Cited by 2 publications

(2 citation statements)

References 11 publications

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“…Therefore, abnormal values of urea concentration in the blood is an indirect confirmation of several pathologies. In fact, an excess of urea in the blood, higher than 6.7 mM, can be due to a low blood flow toward the kidneys as a consequence of cardiac dysfunctions, chronic stress, bleeding from the gastrointestinal tract, high protein diet, or dehydration . On the other hand, low urea concentration in blood suggests malnutrition or severe liver disease; it can also be observed in normal pregnant patients …”

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confidence: 99%

Ethane-Bridged Bisporphyrin Conformational Changes As an Effective Analytical Tool for Nonenzymatic Detection of Urea in the Physiological Range

et al. 2018

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Conformational switching induced in ethane-bridged bisporphyrins was used as a sensitive transduction method for revealing the presence of urea dissolved in water via nonenzymatic approach. Bisporphyrins were deposited on solid quartz slides by means of the spin-coating method. Molecular conformations of Zn and Ni monometalated bis-porphyrins were influenced by water solvated urea molecules and their fluorescence emission was modulated by the urea concentration. Absorption, fluorescence and Raman spectroscopies allowed the identification of supramolecular processes, which are responsible for host-guest interaction between the active layers and urea molecules. A high selectivity of the sensing mechanism was highlighted upon testing the spectroscopic responses of bis-porphyrin films to citrulline and glutamine used as interfering agents. Additionally, potential applicability was demonstrated by quantifying the urea concentration in real physiological samples proposing this new approach as a valuable alternative analytical procedure to the traditionally used enzymatic methods.

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confidence: 99%

Ethane-Bridged Bisporphyrin Conformational Changes As an Effective Analytical Tool for Nonenzymatic Detection of Urea in the Physiological Range

et al. 2018

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“…Urinary urea excretion is rarely routinely measured in critically ill patients, and therefore little is known about the combined time courses of plasma urea and its urinary excretion using 24-hour urine samples. [12][13][14] The main objective of this study was to evaluate the overall course of plasma urea and UUE, compared to the course of plasma creatinine and urinary creatinine excretion (UCE) in critically ill patients, to better understand catabolism and renal urea handling in ICU patients.…”

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confidence: 99%

Time course of plasma urea and urinary urea excretion in patients with a prolonged ICU stay

Zijlstra,

Westland,

Volbeda

et al. 2023

Preprint

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Background Whereas urinary creatinine excretion (UCE) is an established marker of muscle mass, both in critically ill and non-critically ill patients, analysis of urinary urea excretion (UUE) may allow estimation of proteolysis that is associated with critical illness. We evaluated the time courses of plasma urea and creatinine as well UUE and UCE in critically ill patients with a prolonged ICU stay. Our goal was to evaluate changes in plasma urea and creatinine in conjunction with their urinary excretion, to get a better understanding of urea handling in ICU patients. Methods From 2002 to 2021, plasma urea and creatinine, UUE and UCE were determined in routinely obtained 24h urine samples between ICU admission and day 30, in adult patients with an ICU-stay ≥28d. Urea-to-creatinine ratios in plasma and urine were calculated. Patients with stage 3 acute kidney injury (AKI) were excluded. Analyses were performed separately for females and males to account for differences in muscle mass. A subanalysis was done in patients with and without AKI during ICU stay. Results Of 47,120 patients, who were admitted to the ICU between 2002 to 2021, 638 patients met the inclusion criteria. During the first 10 days mean±SD plasma urea increased from 9.7±6.0 mmol/L at ICU admission to 12.4±7.9 mmol/L (P <0.001) on day 11 and decreased afterwards with a rate of 0.1 mmol/l/d. UUE peaked at 590±317 mmol/day on day 13 whereas UCE peaked already on day 4. Males had higher plasma urea, plasma creatinine, UUE and UCE than females. Plasma and urinary urea-to-creatinine ratio (UCR) stabilized after day 7, with a gradual increase in plasma UCR and urinary UCR between day 7 and day 30. Similar courses, although less pronounced, were seen in patients without AKI. Conclusion The course of urea in critically ill patients is characterized by an initial rise of both plasma urea and urinary urea excretion, presumably due to increased catabolism of endogenous or exogenous protein in the first week of ICU admission. Subsequently, UUE and UCE declined steadily in a rate that was comparable to the known loss of muscle mass during ICU admission of approximately 1%/day.

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Relationship between nitrogen loss and blood urea nitrogen concentrations in patients requiring continuous renal replacement therapy

Cited by 2 publications

References 11 publications

Ethane-Bridged Bisporphyrin Conformational Changes As an Effective Analytical Tool for Nonenzymatic Detection of Urea in the Physiological Range

Ethane-Bridged Bisporphyrin Conformational Changes As an Effective Analytical Tool for Nonenzymatic Detection of Urea in the Physiological Range

Time course of plasma urea and urinary urea excretion in patients with a prolonged ICU stay

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