Musso Carlos G, Silva Diana, Propato Fernanda, Molina Yeny, Velez-Verbel María de Los Ángeles, Lopez Norbey, Terrasa Sergio, Gozalez-Torres Henry, Aroca-Martinez Gustavo
Ageing Biology Unit, Hospital Italiano de Buenos Aires, Barranquilla, Colombia.
Facultad de Ciencias de la Salud, Universidad Simón Bolívar, Barranquilla, Colombia.
Indian J Nephrol. 2021 May-Jun;31(3):266-270. doi: 10.4103/ijn.IJN_53_20. Epub 2021 Jan 27.
Making an early diagnosis of acute kidney injury (AKI) is crucial. Classical biomarkers are not capable of early detection of AKI, but novel biomarkers that do have this capability are expensive and not universally available. This prospective study attempts to mitigate these limitations through the evaluation of daily urine analysis on patient admitted to a critical care unit in order to detect early AKI.
Daily urinary indices were measured on every patient admitted to the intensive care unit (ICU) from the time of admission until his/her discharge from the ICU or death. This renal monitoring consisted of daily blood and spot morning urine samples in order to measure creatinine, urea, sodium, chloride and potassium in order to calculate the fractional excretion of sodium (FENa), chloride, urea and potassium. The data collected on these patients in the previous days was analyzed to determine whether or not there was a significant statistical difference in the urinary indices one day before the clinical diagnosis of AKI (day - 1) and 2 days before the diagnosis (day - 2). The statistical test applied was a single rank test, using as a limit of significance a value of < 0.05.
Of the 203 patients included, 61 developed AKI. A statistical significant difference was documented only in the value of urinary sodium (UNa) and FENa between day-1 (one day before AKI clinical diagnosis) and day-2 (two days before AKI clinical diagnosis).
Daily monitoring of UNa and FENa detected a significant change in their basal values 24 hours before clinical diagnosis of AKI was made.
急性肾损伤（AKI）的早期诊断至关重要。传统生物标志物无法早期检测出AKI，但具有这种能力的新型生物标志物价格昂贵且并非普遍可用。这项前瞻性研究试图通过评估重症监护病房患者的每日尿液分析来减轻这些局限性，以便检测早期AKI。
对入住重症监护病房（ICU）的每位患者，从入院时起直至其从ICU出院或死亡，每日测量尿液指标。这种肾脏监测包括每日采集血液和晨尿样本，以测量肌酐、尿素、钠、氯和钾，从而计算钠（FENa）、氯、尿素和钾的分数排泄率。分析这些患者前几天收集的数据，以确定在AKI临床诊断前一天（第 - 1天）和诊断前两天（第 - 2天）尿液指标是否存在显著统计学差异。应用的统计检验是单秩检验，显著性界限值为<0.05。
纳入的203例患者中，61例发生了AKI。仅在第 - 1天（AKI临床诊断前一天）和第 - 2天（AKI临床诊断前两天）之间的尿钠（UNa）和FENa值存在统计学显著差异。
对UNa和FENa的每日监测在AKI临床诊断前24小时检测到其基础值有显著变化。
