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Serum urea concentration is probably not related to outcome in ICU patients with AKI and renal replacement therapy.
Nephrol Dial Transplant. 2011 Oct; 26(10):3211-8.ND

Abstract

BACKGROUND

Acute kidney injury (AKI) is a common complication in patients admitted to the intensive care unit (ICU). Among other variables, serum urea concentrations are recommended for timing of initiation of renal replacement therapy (RRT). The aim of this study was to evaluate whether serum urea concentration or different serum urea concentration cutoffs as recommended in the literature were associated with in-hospital mortality at time of initiation of RRT for AKI.

METHODS

This is a retrospective single- centre study during a 3-year period (2004-07), in a 44-bed tertiary care centre ICU of adult AKI patients who were treated with RRT.

RESULTS

Three hundred and two patients were included: 68.9% male, median age 65 years and an APACHE II score of 21. The overall in-hospital mortality was 57.9%. Non-survivors were older (67 versus 64 years, P = 0.016) and had a higher APACHE II score (22 versus 20, P < 0.001). At time of initiation of RRT, they were more severely ill and had a lower serum urea concentration compared to survivors (130 versus 141 mg/dL, P = 0.038). Serum urea concentration, as well as the different historical serum urea concentration cut-offs had low area under the curves for the receiver operating characteristic curve for prediction of mortality. In multivariate analysis, age, and at time of initiation of RRT, potassium, SOFA score with exclusion of points for AKI and RIFLE class were associated with mortality, but serum urea concentration and the different cut-offs were not.

CONCLUSIONS

This retrospective study suggests that serum urea concentration and serum urea concentration cut-offs at time of initiation of RRT have no predictive value for in-hospital mortality in ICU patients with AKI.

Authors+Show Affiliations

Department of Intensive Care Medicine, Ghent University Hospital, Ghent University, Ghent, Belgium. wouter.decorte@azgroeninge.beNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21421593

Citation

De Corte, Wouter, et al. "Serum Urea Concentration Is Probably Not Related to Outcome in ICU Patients With AKI and Renal Replacement Therapy." Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, vol. 26, no. 10, 2011, pp. 3211-8.
De Corte W, Vanholder R, Dhondt AW, et al. Serum urea concentration is probably not related to outcome in ICU patients with AKI and renal replacement therapy. Nephrol Dial Transplant. 2011;26(10):3211-8.
De Corte, W., Vanholder, R., Dhondt, A. W., De Waele, J. J., Decruyenaere, J., Danneels, C., Claus, S., & Hoste, E. A. (2011). Serum urea concentration is probably not related to outcome in ICU patients with AKI and renal replacement therapy. Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, 26(10), 3211-8. https://doi.org/10.1093/ndt/gfq840
De Corte W, et al. Serum Urea Concentration Is Probably Not Related to Outcome in ICU Patients With AKI and Renal Replacement Therapy. Nephrol Dial Transplant. 2011;26(10):3211-8. PubMed PMID: 21421593.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serum urea concentration is probably not related to outcome in ICU patients with AKI and renal replacement therapy. AU - De Corte,Wouter, AU - Vanholder,Raymond, AU - Dhondt,Annemieke W, AU - De Waele,Jan J, AU - Decruyenaere,Johan, AU - Danneels,Christian, AU - Claus,Stefaan, AU - Hoste,Eric A J, Y1 - 2011/03/18/ PY - 2011/3/23/entrez PY - 2011/3/23/pubmed PY - 2012/9/14/medline SP - 3211 EP - 8 JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JO - Nephrol Dial Transplant VL - 26 IS - 10 N2 - BACKGROUND: Acute kidney injury (AKI) is a common complication in patients admitted to the intensive care unit (ICU). Among other variables, serum urea concentrations are recommended for timing of initiation of renal replacement therapy (RRT). The aim of this study was to evaluate whether serum urea concentration or different serum urea concentration cutoffs as recommended in the literature were associated with in-hospital mortality at time of initiation of RRT for AKI. METHODS: This is a retrospective single- centre study during a 3-year period (2004-07), in a 44-bed tertiary care centre ICU of adult AKI patients who were treated with RRT. RESULTS: Three hundred and two patients were included: 68.9% male, median age 65 years and an APACHE II score of 21. The overall in-hospital mortality was 57.9%. Non-survivors were older (67 versus 64 years, P = 0.016) and had a higher APACHE II score (22 versus 20, P < 0.001). At time of initiation of RRT, they were more severely ill and had a lower serum urea concentration compared to survivors (130 versus 141 mg/dL, P = 0.038). Serum urea concentration, as well as the different historical serum urea concentration cut-offs had low area under the curves for the receiver operating characteristic curve for prediction of mortality. In multivariate analysis, age, and at time of initiation of RRT, potassium, SOFA score with exclusion of points for AKI and RIFLE class were associated with mortality, but serum urea concentration and the different cut-offs were not. CONCLUSIONS: This retrospective study suggests that serum urea concentration and serum urea concentration cut-offs at time of initiation of RRT have no predictive value for in-hospital mortality in ICU patients with AKI. SN - 1460-2385 UR - https://www.unboundmedicine.com/medline/citation/21421593/Serum_urea_concentration_is_probably_not_related_to_outcome_in_ICU_patients_with_AKI_and_renal_replacement_therapy_ L2 - https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gfq840 DB - PRIME DP - Unbound Medicine ER -