Urine-to-plasma creatinine ratio and fractional excretion of urea performance in acute-on-chronic kidney disease patients

Excerpt

Acute-on-chronic kidney disease is a common occurrence and is associated with a higher risk of progression to end stage renal disease and death [1]. Correct identification of the acute kidney injury (AKI) mechanism and prognosis is a key component of the clinical management for these patients. Despite its importance, AKI still represents a day-to-day clinical challenge for nephrologists as the diagnostic performance of the commonly used urinary indices remain uncertain in chronic kidney disease (CKD) patients [2, 3]. Recently, the consensus report of the Acute Disease Quality Initiative (ADQI) proposed a new objective definition which distinguishes transient AKI (T-AKI) from acute kidney disease (AKD), based on long-term outcomes after an AKI episode [4]. We aimed to investigate the performance of urine-to-plasma creatinine ratio (U/P Creat) and fractional excretion of urea (FeUrea) to distinguish T-AKI from AKD in acute-on-chronic kidney disease patients. …