Korean Journal of Nephrology 2009;28(3):190-198.
Diagnostic Performance of Fractional Excretion of Urea in Evaluating Patients with Acute Kidney Injury with Diuretics Treatment
Dae Hun Lim, M.D., Ji Min Jeong, M.D., Seul Hyun Oh, M.D., Hyung Chul Lee, M.D., Joon Suk Choi, M.D., Min Jee Kim, M.D., Jeong Woo Park, M.D., Eun Hui Bae, M.D., Seong Kwon Ma, M.D., Nam Ho Kim, M.D. and Soo Wan Kim, M.D.
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
임상연구 : 이뇨제를 사용한 급성 신손상 환자에서 FEUrea의 진단적 유용성
임대훈, 정지민, 오슬현, 이형철, 최준석, 김민지, 박정우, 배은희, 마성권, 김남호, 김수완
전남대학교 의과대학 내과학교실
Abstract
Purpose:Although fractional excretion of sodium (FENa) has been used to distinguish transient-acute kidney injury (T-AKI) from persistent-AKI (P-AKI), the availability of FENa in the diagnosis of T-AKI is reported low in patients with diuretics use. We compared the diagnostic performance of fractional excretion of urea (FEUrea) with that of FENa in patients with diuretics use. Methods:One hundred seven AKI patients were classified as having T-AKIor P-AKI according to the clinical context. Each group was again subdivided according to exposure to diuretics. According to the cut off value generated by receiver operating characteristic (ROC) curves, sensitivity and specificity of FENa and FEUrea were compared with each other. Results:The numbers of patients administered with diuretics were 67 out of total 107 AKI patients (63%), 27 out of 52 (52%) of T-AKI patients, and 40 out of total (65) 55 (73%) of P-AKI patients. When the cutoff value of T-AKI was defined as FENa ≤1.5 and FEUrea ≤30 according to the ROC curves, sensitivity and specificity of FENa were 96% and 100% in non-diuretics group, and 63% and 98% in diuretics group, respectively. Sensitivity and specificity of FEUrea were 92% and 87% in non- diuretics group, and 96% and 83% in diuretics group, respectively. Conclusion:FEUrea is as good as FENa at distinguishing T-AKI from P-AKI in patients administered with diuretics.
Key Words: Urea, Kidney failure, Diuretics


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