Daily Urinary Sodium Excretion Monitoring in Critical Care Setting: A Simple Method for an Early Detection of Acute Kidney Injury

MUSSO, CARLOSG; SILVA, DIANA; PROPATO, FERNANDA; MOLINA, YENY; VELEZ-VERBEL, MARÍA DE LOSÁNGELES; LOPEZ, NORBEY; TERRASA, SERGIO; GOZALEZ-TORRES, HENRY; AROCA-MARTINEZ, GUSTAVO

Indian Journal of Nephrology

Medknow

Año: 2021 vol. 0

0971-4065

Introduction: Making an early diagnosis of acute kidney injury (AKI) is crucial. Classicalbiomarkers are not capable of early detection of AKI, but novel biomarkers that do have thiscapability are expensive and not universally available. This prospective study attempts tomitigate these limitations through the evaluation of daily urine analysis on patient admitted toa critical care unit in order to detect early AKI. Methods: Daily urinary indices were measuredon every patient admitted to the intensive care unit (ICU) from the time of admission untilhis/her discharge from the ICU or death. This renal monitoring consisted of daily blood and spotmorning urine samples in order to measure creatinine, urea, sodium, chloride and potassium inorder to calculate the fractional excretion of sodium (FENa), chloride, urea and potassium. Thedata collected on these patients in the previous days was analyzed to determine whether or notthere was a significant statistical difference in the urinary indices one day before the clinicaldiagnosis of AKI (day ? 1) and 2 days before the diagnosis (day ? 2).The statistical test appliedwas a single rank test, using as a limit of significance a value of P < 0.05. Results: Of the203 patients included, 61 developed AKI. A statistical significant difference was documented onlyin the value of urinary sodium (UNa) and FENa between day‐1 (one day before AKI clinicaldiagnosis) and day‐2 (two days before AKI clinical diagnosis). Conclusion: Daily monitoringof UNa and FENa detected a significant change in their basal values 24 hours before clinicaldiagnosis of AKI was made.