Fractional excretion of sodium and potassium and urinary strong ion difference in the evaluation of persistent AKI in sepsis.
Med Intensiva (Engl Ed)
; 2024 Feb 24.
Article
em En
| MEDLINE
| ID: mdl-38403531
ABSTRACT
OBJECTIVE:
To evaluate the diagnostic performance of FENa (Fractional excretion of sodium), FEK (fractional excretion of potassium) and uSID (urinary strong ion difference) in predicting pAKI in sepsis and septic shock.DESIGN:
Retrospective cohort study.SETTING:
Two intensive care units in Argentina. PATIENTS Adult patients with a confirmed diagnosis of sepsis or septic shock and AKI, and had a urinary biochemistry within 24h of the AKI diagnosis.INTERVENTIONS:
None. MAIN VARIABLES OF INTEREST We evaluated the diagnostic accuracy of FENa, FEK and uSID through a ROC (Receiver Operating Characteristic) curve analysis.RESULTS:
80 patients were included. 40 patients presented pAKI. pAKI group had higher APACHE, SOFA score, and mortality rate. In the ROC curve analysis, uSID had no diagnostic utility (AUC=0.52, p=0.69). FENa presented moderate accuracy showing an AUC of 0.71 (95% CI 0.60-0.83; p=0.001), while FEK presented low accuracy with an AUC of 0.69 (95% CI 0.57-0.80; p=0.04). The optimal Youden point for identifying pAKI was at a FENa higher than 0.51 % with a specificity of 72.5% and a sensitivity of 65.0%. In the case of FEK, a value higher than 21.9 % presented the best relation, with a specificity of 67.5% and a sensitivity of 65.0%.CONCLUSIONS:
urine biochemistry interpretation in septic patients must be revised. FENa and FEK are related to the severity of AKI and could be helpful complementary tools for diagnosing pAKI.
Acute kidney injury; Diferencia de aniones fuertes urinaria; Fracción excretada de potasio; Fracción excretada de sodio; Fractional excretion of potassium; Fractional excretion of sodium; IRA asociada a la sepsis; IRA persistente; Injuria renal aguda; Persistent AKI; Sepsis; Sepsis-associated AKI; Urinary strong ion difference
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Idioma:
En
Revista:
Med Intensiva (Engl Ed)
Ano de publicação:
2024
Tipo de documento:
Article