Association of oliguria with the development of acute kidney injury in the critically ill

Vaara, Suvi T; Parviainen, Ilkka; Pettilä, Ville Yrjö Olavi; Nisula, Sara; Inkinen, Outi; Uusaro, Ari (2016). Association of oliguria with the development of acute kidney injury in the critically ill. Kidney international, 89(1), pp. 200-208. Elsevier 10.1016/j.kint.2015.12.007

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Urine output (UO) criterion may increase the sensitivity of the definition of acute kidney injury (AKI). We determined whether the empirically derived definition for oliguria(<0.5 ml/kg/h) is independently associated with adverse outcome. Data analysis included hourly recorded UO from the prospective, multicenter FINNAKI study conducted in 16 Finnish intensive care units. Confounder-adjusted association of oliguria of different severity and duration primarily with the development of AKI defined by creatinine criterion (Cr-AKI) or renal replacement therapy(RRT) was assessed. Secondarily, we determined the association of oliguria with 90-day mortality. Of the 1966 patients analyzed for the development of AKI, 454 (23.1%) reached this endpoint. Within this AKI cohort, 312 (68.7%)developed Cr-AKI, 21 (4.6%) commenced RRT without Cr-AKI, and 121 (26.7%) commenced RRT with Cr-AKI. Episodes of severe oliguria (<0.1 ml/kg/h) for more than 3 h were independently associated with the development of Cr-AKI or RRT. The shortest periods of consecutive oliguria independently associated with an increased risk for 90-day mortality were 6–12 h of oliguria from 0.3 to <0.5 ml/kg/h, over 6 h of oliguria from 0.1 to <0.3 ml/kg/h, and severe oliguria lasting over 3 h.Thus, our findings underlie the importance of hourly UO measurements.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care

UniBE Contributor:

Pettilä, Ville Yrjö Olavi

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1523-1755

Publisher:

Elsevier

Language:

English

Submitter:

Mirella Aeberhard

Date Deposited:

02 Aug 2016 11:46

Last Modified:

02 Aug 2016 11:46

Publisher DOI:

10.1016/j.kint.2015.12.007

PubMed ID:

27169784

URI:

https://boris.unibe.ch/id/eprint/84809

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