Ralib et al. report that urine output (UO) <0.3 ml/kg/h for >6 h predicts a composite outcome of mortality and dialysis requirement in critically ill patients. Their findings validate UO as a marker of acute kidney injury, but raise the question of whether the diagnostic thresholds should be more stringent.
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References
Legrand, M. & Payen, D. Understanding urine output in critically ill patients. Ann. Intensive Care 1, 13 (2011).
Mehta, R. L. et al. Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit. Care 11, R31 (2007).
Macedo, E., Malhotra, R., Bouchard, J., Wynn, S. K. & Mehta, R. L. Oliguria is an early predictor of higher mortality in critically ill patients. Kidney Int. 80, 760–767 (2011).
Macedo, E., Malhotra, R., Claure-Del Granado, R., Fedullo, P. & Mehta, R. L. Defining urine output criterion for acute kidney injury in critically ill patients. Nephrol. Dial. Transplant. 26, 509–515 (2011).
Mandelbaum, T. et al. Empirical relationships among oliguria, creatinine, mortality, and renal replacement therapy in the critically ill. Intensive Care Med. 39, 414–419 (2013).
Prowle, J. R. et al. Oliguria as predictive biomarker of acute kidney injury in critically ill patients. Crit. Care 15, R172 (2011).
Wlodzimirow, K. A. et al. A comparison of RIFLE with and without urine output criteria for acute kidney injury in critically ill patients. Crit. Care 16, R200 (2012).
Ralib, A. M., Pickering, J. W., Shaw, G. M. & Endre, Z. H. The urine output definition of acute kidney injury is too liberal. Crit. Care 17, R112 (2013).
Solomon, A. W. et al. Urine output on an intensive care unit: case-control study. BMJ 341, c6761 (2010).
Mehta, R. L. M. et al. Potential use of biomarkers in acute kidney injury: report and summary of recommendations from the 10th Acute Dialysis Quality Initiative Consensus Conference. Kidney Int. (in press).
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Mehta, R. Urine output in AKI—the canary in the coal mine?. Nat Rev Nephrol 9, 568–570 (2013). https://doi.org/10.1038/nrneph.2013.178
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DOI: https://doi.org/10.1038/nrneph.2013.178
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