Carrillo-Esper R, Pérez-Calatayud ÁA, Peña-Pérez CA, Díaz-Carrillo MA, Nava-López JA, de los Monteros-Estrada IE, Zepeda-Mendoza AD

Language: Spanish
References: 19
Page: 602-606
PDF size: 394.51 Kb.

ABSTRACT

Urine microscopy is one of the most commonly used markers for diagnosis of acute kidney injury, but its performance hasn’t been adequately studied in acute kidney injury secondary to sepsis. This paper reports the case of two patients with acute kidney injury secondary to sepsis in which fresh urine samples were obtained and urinary sediment was examined. We evaluated the urinary microscopic score on the basis of cast and renal tubular epithelial cells. Measurements of blood urea nitrogen, creatinine and NGAL were performed. A high urinary microscopic sediment score had a good correlation with other markers of renal dysfunction; thus, we consider that evaluation of urine microscopic sediment score in acute kidney injury secondary to sepsis is a valuable tool.

REFERENCES

1. Nash K, Hafeez A, Hou S. Hospital-acquired renal insufficiency. Am J Kidney Dis 2002;39:930-936.

2. Uchino S, Kellum JA, Bellomo R, Doig GS, et al. Acute renal failure in critically ill patients: a multinational, multicenter study. JAMA 2005;294:813-818.

3. Wald R, Quinn RR, Luo J, Li P, et al. Chronic dialysis and death among survivors of acute kidney injury requiring dialysis. JAMA 2009;302:1179-1185.

4. Bagshaw SM, Uchino S, Bellomo R, Morimatsu H, et al. Septic acute kidney injury in critically ill patients: clinical characteristics and outcomes. Clin J Am Soc Nephrol 2007;2:431-439.

5. Oppert M, Engel C, Brunkhorst FM, Bogatsch H, et al. Acute renal failure in patients with severe sepsis and septic shock—a significant independent risk factor for mortality: results from the German Prevalence Study. Nephrol Dial Transplant 2008;23:904-909.

6. Bagshaw SM, George C, Bellomo R. Early acute kidney injury and sepsis: a multicentre evaluation. Crit Care 2008;12:R47.

7. Ishikawa K, May CN, Gobe G, Langenberg C, Bellomo R. Pathophysiology of septic acute kidney injury: a different view of tubular injury. Contrib Nephrol 2010;165:18-27.

8. Wan L, Bagshaw SM, Langenberg C, Saotome T, et al. Pathophysiology of septic acute kidney injury: what do we really know? Crit Care Med 2008;36:S198-S203.

9. May C, Wan L, Williams J, Wellard MR, Pell G, Langenberg C. A technique for the simultaneous measurement of renal ATP, blood flow and pH in a large animal model of septic shock. Crit Care Resusc 2007;9:30-33.

10. Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P. Acute renal failure definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care 2004;8:R204-R212.

11. Mehta RL, Kellum JA, Shah SV, Molitoris BA, Ronco C, Warnock DG. Report of an initiative to improve outcomes in acute kidney injury. Crit Care 2007;11:R31.

12. Bagshaw SM, Langenberg C, Bellomo R. Urinary biochemistry and microscopy in septic acute renal failure: a systematic review. Am J Kidney Dis 2006;48:695-705.

13. Bagshaw SM, Langenberg C, Wan L, May CN, Bellomo R. A systematic review of urinary findings in experimental septic acute renal failure. Crit Care Med 2007;35:1592-1598.

14. Perazella MA, Coca SG, Kanbay M, Brewster UC, Parikh CR. Diagnostic value of urine microscopy for differential diagnosis of acute kidney injury in hospitalized patients. Clin J Am Soc Nephrol 2008;3:1615-1619.

15. Chawla LS, Dommu A, Berger A, Shih S, Patel SS. Urinary sediment cast scoring index for acute kidney injury: a pilot study. Nephron Clin Pract 2008;110:c145-c150.

16. Marcussen N, Schumann J, Campbell P, Kjellstrand C. Cytodiagnostic urinalysis is very useful in the differential diagnosis of acute renal failure and can predict the severity. Ren Fail 1995;17:721-729.

17. Perazella MA, Coca SG, Hall IE, Iyanam U, et al. Urine microscopy is associated with severity and worsening of acute kidney injury in hospitalized patients. Clin J Am Soc Nephrol 2010;5:402-408.

18. Bagshaw SM, Haase M, Fielitz H, Bennett M, et al. A prospective evaluation of urine microscopy in septic and non-septic acute kidney injury. Nephrol Dial Transplant 2012;27:582-588.

19. Perazella MA, Coca SG, Kanbay M, Brewster UC, Parikh CR. Diagnostic utility of urine microscopy in the differential diagnosis of acute kidney injury. Clin J Am Soc Nephrol 2008;3:1615-1619.