Fractional Excretion of Urea in Pediatric Patients with Acute Kidney Injury

Authors : Özlem Yüksel AKSOY, Zehra AYDIN, Mihriban İNÖZÜ, Begüm AVCI, Fatma Şemsa ÇAYCI, Umut Selda BAYRAKÇI

Pages : 91-95

Doi:10.12956/tchd.1036384

View : 11 | Download : 5

Publication Date : 2023-03-22

Article Type : Research Paper

Abstract :Objective: Fractional excretion of sodium insert ignore into journalissuearticles values(FeNa); and fractional excretion of urea insert ignore into journalissuearticles values(FeU); are used to differentiate prerenal and renal injuries in acute kidney injury insert ignore into journalissuearticles values(AKI);. In this study, we aimed to compare the discriminative power of FeU with FeNa between prerenal and renal azotemia groups as well as among AKI stages according to pRIFLE criteria. Material and Methods: Laboratory and medical records of 55 pediatric AKI patients who had the measurements of random urine excretions of urea, creatinine and sodium as well as serum urea, creatinine and sodium levels in order to calculate FeU and FeNa values at the time of AKI diagnosis were evaluated retrospectively. Patients were divided into prerenal and renal injury groups according to the clinical findings and laboratory data. Sensitivities and specifities of FeNa and FeU in differentiating prerenal versus renal injury were determined. FeNa and FeU values were compared in patients with different RIFLE stages. Results: Among 55 pediatric AKI patients 31 were boys, 24 were girls. The mean age at the time of diagnosis was 71.1 ± 83.5 months insert ignore into journalissuearticles values(min-max: 1-216);. When we grouped the patients as having FeU<35% and FeU≥35%, the difference between the numbers of the patients in prerenal and renal groups was significant insert ignore into journalissuearticles values(p=0.039);. The sensitivity and specificity of FeU to determine prerenal vs renal injury were calculated as 50% and 77.1% respectively. When FeNa and FeU were used together insert ignore into journalissuearticles values(FeNa>1% and FeU>35%); in order to distinguish prerenal and renal injuries the specificity increased to 81% insert ignore into journalissuearticles values(p=0.020);. Mean FeU was significantly different between AKI stages insert ignore into journalissuearticles values(p=0.022);, and was higher in Injury and Failure stages when compared with the Risk stage. Conclusion: Fractional urea excretion is as important as FeNa in evaluating children with AKI. We recommend to obtain FeU in pediatric AKI in order to differentiate prerenal and renal etiology and to differentiate the severity of the injury according to the AKI stages in order to arrange the treatment.
Keywords : Akut böbrek hasarı, fraksiyone üre ekskresyonu, pRIFLE