Urine Output and the Diagnosis of Acute Kidney Injury
Prevention and management of organ dysfunction are central to the practice of critical care medicine. To this end, physiological monitoring is used to assess organ function and the effects of treatment in real time. One of the foremost challenges for the intensive care specialist is to understand how to relate physiological variables, such as oxygenation, blood pressure and cardiac output, to underlying organ function. These relationships are complex and reflect interdependence of organ function, treatment, disease and comorbid conditions. Nevertheless, in search of patterns to guide clinical management, we commonly relate certain measurements to the function of particular organs, such as blood pressure and cardio-circulatory function. In the case of the kidneys, maintenance of urine output is a continuous manifestation of organ function and urine production is both monitored as an index of organ function and targeted as a therapeutic goal. However, in common with other continuously monitored physiological variables, the relationship between urine output and underlying kidney function is complex and there are many pitfalls to its interpretation in isolation.
KeywordsRenal Replacement Therapy Acute Kidney Injury Urine Output Renal Blood Flow Renal Plasma Flow
Unable to display preview. Download preview PDF.
- 5.Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P (2004) Acute renal failure — definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care 8: R204–212CrossRefGoogle Scholar
- 8.Kidney Disease: Improving Global Outcomes (KDIGO) Available at: http://www.kdigo.org Accessed Nov 2011Google Scholar
- 10.Gamble JL (1946) Physiological information gained from studies of the life raft ration. Harvey Lect 42: 247–278Google Scholar
- 29.Haase M, Bellomo R, Matalanis G, Calzavacca P, Dragun D, Haase-Fielitz A (2009) A comparison of the RIFLE and Acute Kidney Injury Network classifications for cardiac surgery-associated acute kidney injury: a prospective cohort study. J Thorac Cardiovasc Surg 138: 1370–1376PubMedCrossRefGoogle Scholar
- 32.Han SS, Kang KJ, Kwon SJ, et al (2012) Additional role of urine output criterion in defining acute kidney Injury. Nephrol Dial Transplant (in press)Google Scholar