Urinary Biochemistry in the Diagnosis of Acute Kidney Injury

Disease Markers
Camila Lima, Etienne Macedo

Abstract

Acute kidney injury (AKI) is a common complication, impacting short- and long-term patient outcomes. Although the application of the classification systems for AKI has improved diagnosis, early clinical recognition of AKI is still challenging, as increments in serum creatinine may be late and low urine output is not always present. The role of urinary biochemistry has remained unclear, especially in critically ill patients. Differentiating between a transient and persistent acute kidney injury is of great need in clinical practice, and despite studies questioning their application in clinical practice, biochemistry indices continue to be used while we wait for a novel early injury biomarker. An ideal marker would provide more detailed information about the type, intensity, and location of the injury. In this review, we will discuss factors affecting the fractional excretion of sodium (FeNa) and fractional excretion of urea (FeU). We believe that the frequent assessment of urinary biochemistry and microscopy can be useful in evaluating the likelihood of AKI reversibility. The availability of early injury biomarkers could help guide clinical interventions.

References

Jul 1, 1978·Annals of Internal Medicine·T R MillerR W Schrier
Jan 1, 1990·American Journal of Nephrology·K S KamelM L Halperin
May 1, 1969·Journal of Applied Physiology·M H GoldsteinM F Levitt
Oct 1, 1984·The American Journal of Medicine·R W Steiner
May 1, 1982·Annals of Internal Medicine·J R Diamond, D C Yoburn
Mar 5, 1998·The New England Journal of Medicine·S Klahr, S B Miller
Jun 26, 2002·Kidney International·Won K HanJoseph V Bonventre
Nov 6, 2002·Annals of Internal Medicine·Matthew L Esson, Robert W Schrier
Nov 13, 2002·Kidney International·Christos P CarvounisSamerah Guro-Razuman
Feb 15, 2003·JAMA : the Journal of the American Medical Association·Naveen SingriMurray L Levin
Feb 24, 2004·Archives of Disease in Childhood. Fetal and Neonatal Edition·S OddieJ Wyllie
Oct 25, 2006·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Sean M BagshawRinaldo Bellomo
Dec 28, 2006·Kidney International·J A Armstrong
Jan 19, 2007·American Journal of Physiology. Renal Physiology·Christoph SchmidtMichael Bucher
Apr 25, 2007·Critical Care Medicine·Sean M BagshawRinaldo Bellomo
Aug 24, 2007·The New England Journal of Medicine·J Gary Abuelo
Sep 29, 2007·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Marie-Noëlle PépinJean Ethier
Mar 14, 2008·Clinical Journal of the American Society of Nephrology : CJASN·Michael BennettPrasad Devarajan
Apr 26, 2008·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Ulf SchönermarckWalter Samtleben
Sep 12, 2008·Clinical Journal of the American Society of Nephrology : CJASN·Mark A PerazellaChirag R Parikh
Oct 28, 2008·Nephron. Clinical Practice·Lakhmir S ChawlaSamir S Patel
Apr 25, 2009·Journal of the American Society of Nephrology : JASN·Kent DoiRobert A Star
Sep 19, 2009·Journal of the American Society of Nephrology : JASN·Isaac E HallChirag R Parikh
Nov 6, 2009·Nephron. Clinical Practice·Charles J DiskinThomas B Carter
Apr 30, 2010·Contributions to Nephrology·Dinna N CruzZaccaria Ricci
May 13, 2010·Critical Care : the Official Journal of the Critical Care Forum·Etienne MacedoUNKNOWN Program to Improve Care in Acute Renal Disease Study
Jun 22, 2010·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Etienne MacedoRavindra L Mehta
Jun 11, 2011·International Journal of Nephrology·Kenneth YongWai Lim
Jun 15, 2011·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Sean M BagshawRinaldo Bellomo
Jul 1, 2011·Kidney International·Etienne MacedoRavindra L Mehta
Jul 21, 2011·Critical Care : the Official Journal of the Critical Care Forum·John R ProwleRinaldo Bellomo
Jul 29, 2011·Critical Care : the Official Journal of the Critical Care Forum·Michael DarmonBenoit Schlemmer
Aug 20, 2011·Journal of the American Society of Nephrology : JASN·Robert W Schrier
Nov 19, 2011·Clinical Journal of the American Society of Nephrology : CJASN·Mark A Perazella, Steven G Coca
Apr 24, 2012·Journal of Critical Care·Antoine DewitteFrançois Sztark
Apr 25, 2012·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Carrie A SchinstockJohn C Lieske
Sep 8, 2012·Current Opinion in Critical Care·John ProwleRinaldo Bellomo
Nov 20, 2012·Journal of Critical Care·Sean M BagshawRinaldo Bellomo
Apr 23, 2013·Enfermedades infecciosas y microbiología clínica·Mario Fernández-RuizJosé María Aguado
May 11, 2013·Critical Care : the Official Journal of the Critical Care Forum·Antoine G Schneider, Rinaldo Bellomo
Jul 17, 2013·Clinical Chemistry and Laboratory Medicine : CCLM·Anne-Sophie BargnouxJean-Paul Cristol
Oct 15, 2013·Critical Care : the Official Journal of the Critical Care Forum·Jill VanmassenhoveWim Van Biesen

❮ Previous
Next ❯

Citations

Mar 7, 2020·Journal of Clinical Medicine·Joana GameiroJosé António Lopes
Feb 23, 2020·Medizinische Klinik, Intensivmedizin und Notfallmedizin·Johannes SzaszMartin Dünser
Jul 14, 2020·Electrolyte & Blood Pressure : E & BP·Myeong Su ParkMinah Kim
Aug 28, 2020·Case Reports in Medicine·Vivian O ChukwurahHakan R Toka
Aug 8, 2019·Annals of Intensive Care·Joana Gameiro, José António Lopes
Jun 6, 2020·Journal of Clinical Medicine·Joana GameiroJosé António Lopes
Jul 16, 2020·Scientific Reports·Víctor Blanco-GozaloFrancisco J López-Hernández
Oct 3, 2018·Journal of Clinical Medicine·Joana GameiroJose Antonio Lopes
Aug 2, 2019·International Journal of Molecular Sciences·Justyna WajdaBeata Kuśnierz-Cabala
Jun 26, 2020·Clinical and Experimental Nephrology·Kent Doi
Nov 26, 2020·The British Journal of Radiology·Yi WangBin Song
Dec 9, 2020·Zeitschrift für Gastroenterologie·Florian Gunnar ScurtChristos Chatzikyrkou
Mar 18, 2021·Zeitschrift für Gastroenterologie·Florian Gunnar ScurtChristos Chatzikyrkou
Jul 29, 2021·Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine·Nadikuda Sunil KumarSurya Y Prakash
Aug 10, 2021·Journal of the American Heart Association·Kazutaka NogiYoshihiko Saito
Oct 27, 2021·Veterinary Clinical Pathology·Casey A DropkinDaniel K Langlois

❮ Previous
Next ❯

Methods Mentioned

BETA
biopsy

Related Concepts

Related Feeds