Durakovic Z, Durakovic A, Durakovic S
Department of Internal Medicine, Rebro University Hospital, Medical Faculty, University of Zagreb, Croatia, Yugoslavia.
Ren Fail. 1989;11(4):213-9. doi: 10.3109/08860228909054934.
In 55 patients with either the oliguric and nonoliguric form of acute renal failure, some laboratory parameters for the analysis of prerenal and intrinsic types of acute renal failure were examined. The parameters were analyzed within 7 days of the clinically known beginning of the illness. The parameters were analyzed as follows: sodium in urine, creatinine urine/plasma ratio, urine osmolality, osmolality urine/plasma ratio, renal failure index, and fractional excretion of filtered sodium. Hemodialysis was performed in 29 of the 55 patients. The oliguric form of acute renal failure was present in 49 of the 55 patients. In relation to renal failure index, prerenal acute renal failure was present in 7 patients and intrinsic acute renal failure in 48. It appears that in patients with a clinical diagnosis of prerenal acute renal failure, the urinary parameters do not separate them from those with acute tubular necrosis. It also appears that in patients with laboratory diagnosis of prerenal acute renal failure (i.e., a RFT less than 1.0), the response to treatment is unpredictable and in fact may have a worse prognosis than in those with a RFI greater than 1.0 (5/7 deaths vs 10/48 deaths).
对55例急性肾衰竭少尿型和非少尿型患者，检测了一些用于分析肾前性和肾内性急性肾衰竭的实验室参数。这些参数在临床明确发病开始后的7天内进行分析。分析的参数如下：尿钠、尿肌酐/血肌酐比值、尿渗透压、尿渗透压/血渗透压比值、肾衰竭指数及滤过钠排泄分数。55例患者中有29例进行了血液透析。55例患者中49例为急性肾衰竭少尿型。就肾衰竭指数而言，7例为肾前性急性肾衰竭，48例为肾内性急性肾衰竭。似乎临床诊断为肾前性急性肾衰竭的患者，其尿液参数并不能将他们与急性肾小管坏死患者区分开来。同样似乎实验室诊断为肾前性急性肾衰竭（即肾衰竭指数小于1.0）的患者，其治疗反应不可预测，事实上其预后可能比肾衰竭指数大于1.0的患者更差（死亡5/7例 vs 死亡10/48例）。
