Focused on pre-renal acute kidney injury – has the time come to rewrite the textbooks?

Czech version

Authors: Prof. MUDr. Martin Matějovič, Ph.D.
Authors‘ workplace: Biomedicínské centrum, Lékařská fakulta v Plzni, Univerzita Karlova v Praze, Fakultní nemocnice Plzeň ; I. interní klinika, Lékařská fakulta v Plzni, Univerzita Karlova v Praze
Published in: Anest. intenziv. Med., 25, 2014, č. 1, s. 25-28
Category: Intesive Care Medicine - Special Article

Overview

Acute kidney injury (AKI) represents a wide spectrum of changes ranging from purely “functional” to completely structural kidney damage. In medical textbooks, both the fractional excretion of sodium and serum blood urea nitrogen to creatinine ration have been long considered as valuable tools to differentiate between prerrenal AKI (PRA) and established acute tubular necrosis (ATN). Recent data suggest that these traditional biomarkers used to distinguish PRA from ATN are insufficiently reliable to be clinical relevant. This article is a brief commentary on the most recent studies evaluating the diagnostic value and prognostic ability of these widely accepted blood and urine parameters in critically ill patients.

Keywords:
acute kidney Indry – fractional excretion of sodium – pre-renal azotemia

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Article was published in

Anaesthesiology and Intensive Care Medicine

2014 Issue 1