ArticleClinical journal of the American Society of Nephrology : CJASN2014
Derivation of urine output thresholds that identify a very high risk of AKI in patients with septic shock.
Article in Clinical journal of the American Society of Nephrology : CJASN, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.
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Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The Japanese clinical practice guideline for acute kidney injury 2016.Clinical and experimental nephrology · 2018Guideline
- Sepsis criteria and kidney function: eliminating sex, age and economic status biases.Nature reviews. Nephrology · 2025Review
- The combination of kidney function variables with cell cycle arrest biomarkers identifies distinct subphenotypes of sepsis-associated acute kidney injury: aRenal failure · 2024Article
- Epidemiology of sepsis-associated acute kidney injury in critically ill patients: a multicenter, prospective, observational cohort study in South Korea.Critical care (London, England) · 2024Observational
- Redefining urine output thresholds for acute kidney injury criteria in critically Ill patients: a derivation and validation study.Critical care (London, England) · 2024Article
- Association between 24-hour urine volume and 28-day intensive care unit mortality in sepsis patients: a multi-center retrospective cohort study.Frontiers in medicine · 2024Article
- A Machine Learning Algorithm Predicting Acute Kidney Injury in Intensive Care Unit Patients (NAVOY Acute Kidney Injury): Proof-of-Concept Study.JMIR formative research · 2023Article
- Serum cystatin C, kidney injury molecule-1, neutrophil gelatinase-associated lipocalin, klotho and fibroblast growth factor-23 in the early prediction of acute kidney injury associated with sepsis in a Chinese emergency cohort study.European journal of medical research · 2022Observational
- Acute kidney injury detection using refined and physiological-feature augmented urine output.Scientific reports · 2021Article
- Sepsis-Associated Acute Kidney Injury.Critical care clinics · 2021Review
- Including urinary output to define AKI enhances the performance of machine learning models to predict AKI at admission.Journal of critical care · 2021Article
- Urine Output Is Associated With In-hospital Mortality in Intensive Care Patients With Septic Shock: A Propensity Score Matching Analysis.Frontiers in medicine · 2021Article
- Re-evaluating Renal Angina Index: An Authentic, Evidence-Based Instrument for Acute Kidney Injury Assessment: Critical Appraisal.Frontiers in pediatrics · 2021Article
- The clinical relevance of oliguria in the critically ill patient: analysis of a large observational database.Critical care (London, England) · 2020Observational
- Definition of hourly urine output influences reported incidence and staging of acute kidney injury.BMC nephrology · 2020Observational
- Acute Kidney Injury: A Frequently Underestimated Problem in Perioperative Medicine.Deutsches Arzteblatt international · 2019Review
- Acute kidney injury from sepsis: current concepts, epidemiology, pathophysiology, prevention and treatment.Kidney international · 2019Review
- A simple score to predict severe leptospirosis.PLoS neglected tropical diseases · 2019Article
- Intraoperative Urine Output Is Associated with Postoperative Outcome in Pediatric Population Undergone Major Abdominal Operations.Therapeutics and clinical risk management · 2019Article
- The Japanese Clinical Practice Guideline for acute kidney injury 2016.Journal of intensive care · 2018Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesTo promote early detection of AKI, recently proposed pretest probability models combine sub-Kidney Disease Improving Global Outcomes (KDIGO) AKI criteria with baseline AKI risk. The primary objective of this study was to determine sub-KDIGO thresholds that identify patients with septic shock at highest risk for AKI. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This was a retrospective analysis of 390 adult patients admitted to the medical intensive care unit (ICU) of a tertiary, academic medical center with septic shock between January 2008 and December 2010. Hourly urine output was collected from the time of septic shock recognition (hour 0) to hour 96, urine catheter removal, or ICU discharge (whichever occurred first). All available serum creatinine (SCr) measurements were collected until hour 96. The AKI pretest probability model was assessed during the first 12 hours of resuscitation and included the initial episode of oliguria, increase from baseline to peak SCr level, and Acute Physiology and Chronic Health Evaluation (APACHE) III score in a multivariable receiver-operator characteristic (ROC) analysis. The primary outcome was the incidence of stage II or III (stage II+) AKI defined by KDIGO criteria. Secondary outcomes included the need for RRT and 28-day mortality.
resultsNinety-eight (25%) patients developed stage II+ AKI after septic shock recognition. APACHE III score and increase in SCr level in the first 12 hours were not statistically associated with stage II+ AKI in multivariable ROC analysis. Consecutive oliguria for 3 hours had fair predictive ability for achieving stage II+ AKI criteria (area under ROC curve, 0.73; 95% confidence interval [95% CI], 0.68 to 0.78), and oliguria for 5 hours demonstrated optimal accuracy (82%; 95% CI, 79% to 86%).
conclusionsThree to 5 hours of consecutive oliguria in patients with septic shock may provide a valuable measure of AKI risk. Further validation to support this finding is needed.
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