Markl-Le Levé Andreas, Hillinger Petra, Woyke Simon, Ronzani Marco, Schmid Stefan, Kreutziger Janett, Rugg Christopher
Department of Anaesthesiology and Critical Care Medicine, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.
Diagnostics (Basel). 2025 Jun 1;15(11):1408. doi: 10.3390/diagnostics15111408.
An elevated urea-creatinine ratio (UCR) is used as a surrogate for catabolism and elevated protein metabolism in critically ill patients. This study investigated the effect of continuous renal replacement therapy (CRRT) on UCR. In this retrospective single-centre study, ICU patients from 2011 to 2022 with an ICU stay >2 days before CRRT and a CRRT duration of ≥4 days were included. Patients were grouped by UCR at CRRT initiation into high (UCR ≥ 75 mg/dL:mg/dL) and low groups and compared to matched controls not requiring CRRT. Propensity score matching considered age, sex, bodyweight, SAPS3, SOFA score, and UCR values on baseline and pre-baseline days. In the high UCR group, UCR significantly decreased after CRRT initiation, reaching a significant difference from controls on day 2 (85.0 [IQR: 69.5-96.4] vs. 94.4 [IQR: 83.0-115.2]; = 0.036) and falling below the threshold of 75 by day 3. In the low group, UCR increased post-CRRT initiation, but was less pronounced than in controls, with significant differences on day 1 (44.0 [IQR: 34.2-59.8] vs. 40.6 [IQR: 32.1-52.5]; = 0.024). CRRT significantly affects UCR in critically ill patients, showing a marked decrease when compared to matched controls.
尿素肌酐比值（UCR）升高被用作危重症患者分解代谢和蛋白质代谢增强的替代指标。本研究调查了连续性肾脏替代治疗（CRRT）对UCR的影响。在这项回顾性单中心研究中，纳入了2011年至2022年入住重症监护病房（ICU）且在开始CRRT前住院时间>2天、CRRT持续时间≥4天的患者。根据CRRT开始时的UCR将患者分为高UCR组（UCR≥75mg/dL:mg/dL）和低UCR组，并与不需要CRRT的匹配对照组进行比较。倾向评分匹配考虑了年龄、性别、体重、简化急性生理学评分第3版（SAPS3）、序贯器官衰竭评估（SOFA）评分以及基线和基线前几天的UCR值。在高UCR组中，CRRT开始后UCR显著下降，在第2天与对照组有显著差异（85.0[四分位间距：69.5 - 96.4] vs. 94.4[四分位间距：83.0 - 115.2]；P = 0.036），并在第3天降至75以下。在低UCR组中，CRRT开始后UCR升高，但不如对照组明显，在第1天有显著差异（44.0[四分位间距：34.2 - 59.8] vs. 40.6[四分位间距：32.1 - 52.5]；P = 0.024）。CRRT对危重症患者的UCR有显著影响，与匹配对照组相比有明显下降。
