Combining creatinine and volume kinetics identifies missed cases of acute kidney injury following cardiac arrest.

ABSTRACT:

Introduction

Fluid resuscitation in the critically ill often results in a positive fluid balance, potentially diluting the serum creatinine concentration and delaying diagnosis of acute kidney injury (AKI).

Methods

Dilution during AKI was quantified by combining creatinine and volume kinetics to account for fluid type, and rates of fluid infusion and urine output. The model was refined using simulated patients receiving crystalloids or colloids under four glomerular filtration rate (GFR) change scenarios and then applied to a cohort of critically ill patients following cardiac arrest.

Results

The creatinine concentration decreased during six hours of fluid infusion at 1 litre-per-hour in simulated patients, irrespective of fluid type or extent of change in GFR (from 0

SUBMITTER: Pickering JW 

PROVIDER: S-EPMC4056623 | biostudies-literature | 2013 Jan

REPOSITORIES: biostudies-literature