Urinary Strong Ion Difference as a Marker of Renal Dysfunction. A Retrospective Analysis

Balsorano, Paolo; Romagnoli, Stefano; Evans, Samuel K.; Ricci, Zaccaria; Gaudio, Angelo Raffaele De

doi:10.1371/journal.pone.0156941

Cited by 6 publications

(3 citation statements)

References 25 publications

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“…16,27,28 Balsorano et al demonstrated similar findings in their study, albeit not with the investigation of chloride excretion. 21 However, on direct measurement of urinary ammonium, we did not find a significant decrease in its concentration. The reason for this is unclear.…”

Section: Discussioncontrasting

confidence: 56%

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Urinary Chloride Excretion Postcardiopulmonary Bypass in Pediatric Patients—A Pilot Study

Fincher

Gibbons

Johnson

et al. 2021

J Pediatr Intensive Care

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The aim of this study was to describe renal chloride metabolism following cardiopulmonary bypass (CPB) surgery in pediatric patients. A prospective observational trial in a tertiary pediatric intensive care unit (PICU) with 20 recruited patients younger than 2 years following CPB surgery was conducted. Urinary electrolytes, plasma urea, electrolytes, creatinine, and arterial blood gases were collected preoperatively, on admission to PICU and at standardized intervals thereafter. The urinary and plasma strong ion differences (SID) were calculated from these results at each time point. Fluid input and output and electrolyte and drug administration were also recorded. Median chloride administration was 67.7 mmol/kg over the first 24 hours. Urinary chloride (mmol/L; median interquartile range [IQR]) was 30 (19, 52) prior to surgery, 15 (15, 65) on admission, and remained below baseline until 24 hours. Plasma chloride (mmol/L; median [IQR]) was 105 (98, 107) prior to surgery and 101 (101, 106) on admission to PICU. It then increased from baseline, but remained within normal limits, for the remainder of the study. The urinary SID increased from 49.8 (19.1, 87.2) preoperatively to a maximum of 122.7 (92.5, 151.8) at 6 hours, and remained elevated until 48 hours. Plasma and urinary chloride concentrations were not associated with the development of acute kidney injury. Urinary chloride excretion is impaired after CPB. The urinary SID increase associated with the decrease in chloride excretion suggests impaired production and/or excretion of ammonium by the nephron following CPB, with gradual recovery postoperatively.

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Section: Discussioncontrasting

confidence: 56%

“…The urinary strong ion difference (SID, SID Urine ) was calculated from the collected data, using the following equation 21 :…”

Section: Data Collectionmentioning

confidence: 99%

Urinary Chloride Excretion Postcardiopulmonary Bypass in Pediatric Patients—A Pilot Study

Fincher

Gibbons

Johnson

et al. 2021

J Pediatr Intensive Care

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“…Urinary strong ion difference ([SID] urine ) is used to differentiate renal hyperchloremic metabolic acidosis from non-renal causes (Balsorano et al 2016). Additionally, [SID] urine may help in our understanding of the mechanisms involved in paradoxical aciduria (Constable et al 2009).…”

Section: Introductionmentioning

confidence: 99%

Fractional excretion of electrolytes and paradoxical aciduria in dairy cows with left displaced abomasum

Perotta

Lisbôa²,

Pereira³

et al. 2018

Pesq. Vet. Bras.

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The fractional excretion of electrolytes is used to assess renal function and interpret electrolyte and acid-base imbalances. Left displaced abomasum is a common disorder in dairy cows, which causes hypokalemic, hypochloremic metabolic alkalosis. There is limited information on fractional excretion of electrolytes in cows with displaced abomasum. This study aimed to measure the fractional excretion of sodium, potassium, and chloride and paradoxical aciduria in dairy cows with displaced abomasum. Blood and urine samples were collected from 30 dairy cows before and 24, 48, and 72 h after surgery. The cows were divided into two groups (G1: laparoscopy and G2: laparotomy) with 15 cows each. The concentrations of chloride, sodium, potassium, and creatinine were measured in serum and urine. Urinary pH and packed cell volume were measured. Fractional excretion of sodium, potassium, and chloride and urinary strong ion difference [SID]urine were calculated using published formulas. Cows in both groups showed hypokalemic, metabolic alkalosis before surgery; however, hypochloremia was observed only in G2. Potassium concentration significantly increased 24, 48, and 72 h after surgery in G1 and 48 and 72 h after surgery in G2. There were no significant changes in fractional excretion of sodium, chloride, and potassium and urinary pH and [SID]urine between treatments and time points. Paradoxical aciduria was observed before and 24 h following surgery in G1. Fractional excretion and urinary SID are valuable tools to understand hypochloremic, hypokalemic alkalosis in dairy cows with displaced abomasum, as well as paradoxical aciduria and return of abomasal flux.

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Urine electrolyte measurement as a “window” into renal microcirculatory stress assessment in critically ill patients

Maciel

2018

Journal of Critical Care

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Urinary Strong Ion Difference as a Marker of Renal Dysfunction. A Retrospective Analysis

Cited by 6 publications

References 25 publications

Urinary Chloride Excretion Postcardiopulmonary Bypass in Pediatric Patients—A Pilot Study

Urinary Chloride Excretion Postcardiopulmonary Bypass in Pediatric Patients—A Pilot Study

Fractional excretion of electrolytes and paradoxical aciduria in dairy cows with left displaced abomasum

Urine electrolyte measurement as a “window” into renal microcirculatory stress assessment in critically ill patients

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