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Category: Volume 07 Issue 01 January 2019
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Title: Differentiate Study on Urine Creatinine and Plasma Creatinine of Acute Kidney Injury in Eastern State of Jharkhand, Ranchi, India

Authors: Dr Jitendrakumar Naik, Dr Pooja Agrawal

 DOI: https://dx.doi.org/10.18535/jmscr/v7i1.79

Abstract

 

Background: Acute kidney injury is the sudden impairment of kidney function, resulting in the retention of urea and other nitrogenous waste products normally cleared by the kidney. Main objective of the present study is to compare the urine creatinine and plasma creatinine differential diagnosis of Acute Kidney Injury.

Research Design: Clinical observation and experimental design were done for the purpose of present study.

Method: We are selected in participants for the present study, these consecutive randomly admitted patients in the department of medicine in Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.

Sample: Total 75 Patients were selected in the present study.

Result: Observation of the result in present study in no-diuretic group, it was found that the urine creatinine /plasma creatinine (UCr/PCr) area of ROC curve is (0.745), standard error (0.079), 95% of confidence interval (0.578-0.87) and the level of significant in p-value (0.5) is 0.0020; while the with-diuretic group of has found the urine creatinine/plasma creatinine area ROC curve is 0.801, standard error (0.072), 95% of confidence interval (0.637-0.913) and the level of significant in p value (0.5) is 0.0001.

Conclusion: Finding of the result concluded that the finding from our study is that Ucr/Pcr was more sensitive but less specific in differentiating prerenal from intrinsic AKI. The sensitivity is more in diuretic exposed group when cutoff value was 43.6364 (p=0.0001). based on these finding it can be good screening test.

Keywords: Urine Creatinine, Plasma Creatinine, Acute Kidney Injury.

References

  1. Chapter 279. Acute Kidney Injury | Harrison's Principles of Internal. https://accessmedicine.mhmedical.com/content.aspx?bookid=331&sectionid.
  2. Khan MY, Deepak P, Kumar AP& TV KK. Study of Etiology, Clinical Profile and Outcome of Acute Kidney Injury (AKI) in Medical Intensive Care Unit.
  3. Liu J, Kumar S, Dolzhenko E, Alvarado GF, Guo J, Lu C, ... &Cippà PE. Molecular characterization of the transition from acute to chronic kidney injury following ischemia/reperfusion. JCI insight, 2017, 2(18).
  4. Pons B, Lautrette A, Oziel J, Dellamonica J, Vermesch R, Ezingeard E, Mariat C, Bernardin G, Zeni F, Cohen Y, Tardy B, Souweine B, Vincent F, … Darmon M. Diagnostic accuracy of early urinary index changes in differentiating transient from persistent acute kidney injury in critically ill patients: multicenter cohort study. Critical care (London, England), 2013, 17(2), R56. doi:10.1186/cc12582.
  5. Darmon M, Vincent F, Dellamonica J, et al. Diagnostic performance of fractional excretion of urea in the evaluation of critically ill patients with acute kidney injury: a multicenter cohort study. Crit Care. 2011;15(4):R178. Published 2011 Jul 27. doi:10.1186/cc10327
  6. Makris K, Spanou L. Acute Kidney Injury: Definition, Pathophysiology and Clinical Phenotypes. ClinBiochem Rev. 2016;37(2):85-98.
  7. Murugan R, Kellum JA. Acute kidney injury: what's the prognosis? Nat Rev Nephrol. 2011;7(4):209-17.
  8. Pickering JW, Endre ZH. The definition and detection of acute kidney injury. J Renal Inj Prev. 2013;3(1):21-5. Published 2013 Nov 30. doi:10.12861/jrip.2014.08
  9. Mehata, RL &Chertow, GM. Acute renal failure definitions and classification: time for change? Journal of American Soc. Nephrol. 2003,14, 2178.
  10. Hou, SH; Bushinsky, DA, Wish, JB et al. Hospital acquired renal insufficiency: a prospective study. Am. J. Med. 1983; 74:243.
  11. Patel SS, Molnar MZ, Tayek JA, Ix JH, Noori N, Benner D, et al. Serum creatinine as a marker of muscle mass in chronic kidney disease: results of a cross-sectional study and review of literature. J Cachexia Sarcopenia Muscle 2013;4:19-29.
  12. Heymsfield SB, Arteaga C, McManus C, Smith J, Moffitt S. Measurement of muscle mass in humans: validity of the 24-hour urinary creatinine method. Am J ClinNutr1983;37:478-94.
  13. Bragadottir G, Redfors B, Ricksten SE. Assessing glomerular filtration rate (GFR) in critically ill patients with acute kidney injury—true GFR versus urinary creatinine clearance and estimating equations. Crit Care 2013;17:R108.
  14. Hoste EA, Damen J, Vanholder RC, Lameire NH, Delanghe JR, Van den Hauwe K, et al. Assessment of renal function in recently admitted critically ill patients with normal serum creatinine. Nephrol Dial Transplant 2005;20:747-53.
  15. Bagshaw SM, Bennett M, Haase M, Haase-Fielitz A, Egi M, Morimatsu H,D’amico G, Goldsmith D, Devarajan P, Bellomo R: Plasma and urineneutrophil gelatinase-associated lipocalin in septic versus non-septicacute kidney injury in critical illness. Intensive Care Med 2010, 36:452-461.
  16. Nickolas TL, O’Rourke MJ, Yang J, Sise ME, Canetta PA, Barasch N, Buchen C, Khan F, Mori K, Giglio J, Devarajan P, Barasch J: Sensitivity and specificityof a single emergency department measurement of urinary neutrophilge-latinase-associated lipocalin for diagnosing acute kidney injury. AnnIntern Med 2008, 148:810-819.
  17. Parikh CR, Mishra J, Thiessen-Philbrook H, Dursun B, Ma Q, Kelly C, Dent C,Devarajan P, Edelstein CL: Urinary IL-18 is an early predictive biomarkerof acute kidney injury after cardiac surgery. Kidney Int 2006, 70:199-203.
  18. Bagshaw SM, Bennett M, Devarajan P, Bellomo R: Urine biochemistry inseptic and non-septic acute kidney injury: a prospective observationalstudy. J Crit Care 2012.
  19. Nejat M, Pickering JW, Devarajan P, Bonventre JV, Edelstein CL, Walker RJ,Endre ZH: Some biomarkers of acute kidney injury are increased in prerenalacute injury. Kidney Int 2012, 81:1254-1262.
  20. Doi K, Negishi K, Ishizu T, Katagiri D, Fujita T, Matsubara T, Yahagi N,Sugaya T, Noiri E: Evaluation of new acute kidney injury biomarkers in amixed intensive care unit. Crit Care Med 2011, 39:2464-2469.
  21. Siew ED, Ware LB, Ikizler TA: Biological markers of acute kidney injury.J Am SocNephrol 2011, 22:810-820.
  22. Susantitaphong P, Altamimi S, Ashkar M et al. GFR at initiation ofdialysis and mortality in CKD: a meta-analysis. Am J Kidney Dis 2012; 59: 829–
  23. Wilson F, Sheehan J, Mariani L, et al. Creatinine generation isreduced in patients requiring continuous venovenous hemodialysis and independently predict mortality. Nephrol Dial Transplant 2012;27: 4088–

Corresponding Author

Dr. Pooja Agrawal (DNB, Medicine)

Assistant Professor, Lakhiram Agrawal Memorial Govt. Medical College, Raigarh, CG, India

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