Читать книгу Acute Kidney Injury - Basic Research and Clinical Practice - Группа авторов - Страница 14

UO is an inexpensive and easy test to evaluate renal function and one of the most important clinical aspects commonly observed by physicians in daily clinical practice in surgical/medical wards, ICUs, and operation theaters. It is a marker of AKI expressed in mL/kg/h, but no consensus on whether to use actual or ideal body weight has been reached so far [18]. Instances of 3 to 5 h of consecutive oliguria in patients with septic shock have shown to provide a valuable measure of AKI risk and to outperform serum creatinine criteria in a “renal angina” window of <12 h [19].

Unfortunately, in many clinical conditions, very common in ICU and perioperative medicine, UO criteria may lack specificity and may be too liberal:

• Most of the critically ill and perioperative patients may have transient periods of oliguria in the absence of decreased GFR. To distinguish such episodes from actual AKI, it may be difficult using the 0.5 mL/kg/h threshold.

• Diuretics are among the most frequently administered drugs in critically ill patients for management of fluid balance. Diuretic administration may hypothetically reverse a diagnosis of AKI based on UO criteria only.