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Diagnostic Implications of Creatinine and Urea Metabolism in Critical Illness

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Annual Update in Intensive Care and Emergency Medicine 2019

Part of the book series: Annual Update in Intensive Care and Emergency Medicine ((AUICEM))

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Abstract

The serum concentrations of urea and creatinine form the basis of our understanding of renal function and are requested and interpreted by critical care clinicians on a near daily basis for patients admitted to intensive care units (ICUs) worldwide. Changes in creatinine constitute the diagnostic criteria for acute kidney injury (AKI) while urea is commonly used as a marker of dehydration and as a potential trigger for initiation of renal replacement therapy (RRT). However, the interpretation of these routinely measured biomarkers of renal function has been brought under scrutiny as the complex impact of critical illness on the metabolism of urea and creatinine affects their interpretation. A more careful understanding of the changes in creatinine and urea metabolism during acute illness and in survivors of critical care is necessary to better inform decisions on diagnosis, treatment strategies and research of new interventions for AKI.

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Authors and Affiliations

  1. Adult Critical Care Unit, The Royal London Hospital, Barts Health NHS Trust, London, UK

    R. W. Haines & J. R. Prowle

  2. William Harvey Research Institute, Queen Mary University of London, London, UK

    R. W. Haines & J. R. Prowle

  3. Department of Renal Medicine and Transplantation, The Royal London Hospital, Barts Health NHS Trust, London, UK

    J. R. Prowle

Authors
  1. R. W. Haines
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Correspondence to J. R. Prowle .

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Editors and Affiliations

  1. Dept. of Intensive Care, Erasme Hospital, Université libre de Bruxelles, Brussels, Belgium

    Jean-Louis Vincent

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Haines, R.W., Prowle, J.R. (2019). Diagnostic Implications of Creatinine and Urea Metabolism in Critical Illness. In: Vincent, JL. (eds) Annual Update in Intensive Care and Emergency Medicine 2019. Annual Update in Intensive Care and Emergency Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-06067-1_25

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  • DOI: https://doi.org/10.1007/978-3-030-06067-1_25

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-06066-4

  • Online ISBN: 978-3-030-06067-1

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