A high urea-to-creatinine ratio predicts long-term mortality independent of acute kidney injury among patients hospitalized with an infection

被引:16
作者
van der Slikke, Elisabeth C. [1 ]
Star, Bastiaan S. [1 ]
de Jager, Vincent D. [1 ]
Leferink, Marije B. M. [2 ]
Klein, Lotte M. [1 ]
Quinten, Vincent M. [3 ]
Olgers, Tycho J. [2 ]
ter Maaten, Jan C. [2 ]
Bouma, Hjalmar R. [1 ,2 ]
机构
[1] Univ Groningen, Univ Med Ctr Groningen, Dept Clin Pharm & Pharmacol, POB 30-001, NL-9700 RB Groningen, Netherlands
[2] Univ Groningen, Univ Med Ctr Groningen, Dept Internal Med, Sect Acute Med, Groningen, Netherlands
[3] Evangel Krankenhaus Oldenburg, Dept Internal Med, Oldenburg, Germany
关键词
CRITICALLY-ILL PATIENTS; ACUTE-RENAL-FAILURE; NITROGEN/CREATININE RATIO; NITROGEN; SERUM; SEPSIS; RISK; EPIDEMIOLOGY; GUIDELINES; INITIATION;
D O I
10.1038/s41598-020-72815-9
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Acute kidney injury (AKI) occurs frequently in patients with sepsis. Persistent AKI is, in contrast to transient AKI, associated with reduced long-term survival after sepsis, while the effect of AKI on survival after non-septic infections remains unknown. As prerenal azotaemia is a common cause of transient AKI that might be identified by an increased urea-to-creatinine ratio, we hypothesized that the urea-to-creatinine ratio may predict the course of AKI with relevance to long-term mortality risk. We studied the association between the urea-to-creatinine ratio, AKI and long-term mortality among 665 patients presented with an infection to the ED with known pre-existent renal function. Long-term survival was reduced in patients with persistent AKI. The urea-to-creatinine ratio was not associated with the incidence of either transient or non-recovered AKI. In contrast, stratification according to the urea-to-creatinine-ratio identifies a group of patients with a similar long-term mortality risk as patients with persistent AKI. Non-recovered AKI is strongly associated with all-cause long-term mortality after hospitalization for an infection. The urea-to-creatinine ratio should not be employed to predict prerenal azotaemia, but identifies a group of patients that is at increased risk for long-term mortality after infections, independent of AKI and sepsis.
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页数:10
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