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Title:The clinical relevance of oliguria in the critically ill patient : analysis of a large observational database
Authors:Vincent, Jean Louis (Author)
Ferguson, Andrew (Author)
Pickkers, Peter (Author)
Jakob, Stephan M. (Author)
Jaschinski, Ulrich (Author)
Almekhlafi, Ghaleb A. (Author)
Leone, Marc (Author)
Mokhtari, Majid (Author)
Fontes, Luis E. (Author)
Bauer, Philippe R. (Author)
Sakr, Yasser (Author)
Tomič, Viktorija (With a unit linked name)
Language:English
Tipology:1.01 - Original Scientific Article
Organisation:Logo UKPBAG - University Clinic of Respiratory and Allergic Diseases Golnik
Abstract:Background: Urine output is widely used as one of the criteria for the diagnosis and staging of acute renal failure, but few studies have specifically assessed the role of oliguria as a marker of acute renal failure or outcomes in general intensive care unit (ICU) patients. Using a large multinational database, we therefore evaluated the occurrence of oliguria (defined as a urine output < 0.5 ml/kg/h) in acutely ill patients and its association with the need for renal replacement therapy (RRT) and outcome. Methods: International observational study. All adult (> 16 years) patients in the ICON audit who had a urine output measurement on the day of admission were included. To investigate the association between oliguria and mortality, we used a multilevel analysis. Results: Of the 8292 patients included, 2050 (24.7%) were oliguric during the first 24 h of admission. Patients with oliguria on admission who had at least one additional 24-h urine output recorded during their ICU stay (n = 1349) were divided into three groups: transient-oliguria resolved within 48 h after the admission day (n = 390 [28.9%]), prolonged-oliguria resolved > 48 h after the admission day (n = 141 [10.5%]), and permanent-oliguria persisting for the whole ICU stay or again present at the end of the ICU stay (n = 818 [60.6%]). ICU and hospital mortality rates were higher in patients with oliguria than in those without, except for patients with transient oliguria who had significantly lower mortality rates than non-oliguric patients. In multilevel analysis, the need for RRT was associated with a significantly higher risk of death (OR = 1.51 [95% CI 1.19%1.91], p = 0.001), but the presence of oliguria on admission was not (OR = 1.14 [95% CI 0.97%1.34], p = 0.103). Conclusions: Oliguria is common in ICU patients and may have a relatively benign nature if only transient. The duration of oliguria and need for RRT are associated with worse outcome.
Keywords:critical care, critical illness, urine, oliguria, kidney, renal insufficiency, kidney diseases, acute kidney failure, mortality, urine output, renal replacement therapy
Year of publishing:2020
Publisher:Springer Nature
Source:Velika Britanija
COBISS_ID:37575171 Link is opened in a new window
UDC:616.1/.4
ISSN on article:1466-609X
OceCobissID:1137983 Link is opened in a new window
DOI:10.1186/s13054-020-02858-x Link is opened in a new window
Note:Nasl. z nasl. zaslona; Opis vira z dne 16. 11. 2020; Sodelavci pri raziskavi iz Slovenije: Gorazd Voga, Erik Rupnik, Lucka Kosec, Milena Kerin Povšic, Irena Osojnik, Viktorija Tomic, Andreja Sinkovic; Article no. 171;
Views:762
Downloads:479
Files:.pdf PDF - Presentation file, download (727,74 KB)
URL URL - Source URL, visit https://ccforum.biomedcentral.com/track/pdf/10.1186/s13054-020-02858-x.pdf
 
Journal:Crit. care
BMC
 
Metadata:XML RDF-CHPDL DC-XML DC-RDF
Rights:© The Author(s). 2020
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License:CC BY 4.0, Creative Commons Attribution 4.0 International
Link:http://creativecommons.org/licenses/by/4.0/
Description:This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.
Licensing start date:23.04.2020

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