oliguria as predictive biomarker of acute kidney injury in critically ill patients少尿的预测生物标志物在危重患者急性肾损伤.pdfVIP

Prowle et al. Critical Care 2011, 15:R172 /content/15/4/R172 RESEARCH Open Access Oliguria as predictive biomarker of acute kidney injury in critically ill patients 1 1 1 2 3 4 4 John R Prowle , Yan-Lun Liu , Elisa Licari , Sean M Bagshaw , Moritoki Egi , Michael Haase , Anja Haase-Fielitz , 5 6 6 7 7 1,8* John A Kellum , Dinna Cruz , Claudio Ronco , Kenji Tsutsui , Shigehiko Uchino and Rinaldo Bellomo Abstract Introduction: During critical illness, oliguria is often used as a biomarker of acute kidney injury (AKI). However, its relationship with the subsequent development of AKI has not been prospectively evaluated. Methods: We documented urine output and daily serum creatinine concentration in patients admitted for more than 24 hours in seven intensive care units (ICUs) from six countries over a period of two to four weeks. Oliguria was defined by a urine output 0.5 ml/kg/hr. Data were collected until the occurrence of creatinine-defined AKI (AKI-Cr), designated by RIFLE-Injury class or greater using creatinine criteria (RIFLE-I[Cr]), or until ICU discharge. Episodes of oliguria were classified by longest duration of consecutive oliguria during each day were correlated with new AKI-Cr the next day, examining cut-offs for oliguria of greater than 1,2,3,4,5,6, or 12 hr duration, Results: We studied 239 patients during 723 days. Overall, 32 patients had AKI on ICU admission, while in 23, AKI- Cr developed in ICU. Oliguria of greater than one hour was significantly associated with AKI-Cr the next day. On receiver-operator characteristic area u