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Tytuł pozycji:

[New kidney function tests: Renal functional reserve and furosemide stress test].

Tytuł:
[New kidney function tests: Renal functional reserve and furosemide stress test].
Autorzy:
Kindgen-Milles D; Klinik für Anästhesiologie, Universitätsklinikum Düsseldorf, Operative Intensivstation im Zentrum für Operative Medizin I, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland. .
Slowinski T; Medizinische Klinik mit Schwerpunkt Nephrologie, Campus Mitte, Charité Universitätsmedizin Berlin, Berlin, Deutschland.
Dimski T; Klinik für Anästhesiologie, Universitätsklinikum Düsseldorf, Operative Intensivstation im Zentrum für Operative Medizin I, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland.
Transliterated Title:
Neue Nierenfunktionstests: Renal-funktionelle Reserve und Furosemidstresstest.
Źródło:
Medizinische Klinik, Intensivmedizin und Notfallmedizin [Med Klin Intensivmed Notfmed] 2020 Feb; Vol. 115 (1), pp. 37-42. Date of Electronic Publication: 2018 Jan 11.
Typ publikacji:
Journal Article; Review
Język:
German
Imprint Name(s):
Original Publication: Heidelberg : Springer Medizin
MeSH Terms:
Acute Kidney Injury*/diagnosis
Diuretics*/administration & dosage
Furosemide*/administration & dosage
Kidney Function Tests*
Creatinine ; Humans ; Kidney/physiopathology ; Renal Replacement Therapy
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Contributed Indexing:
Keywords: Acute kidney injury; Creatinine clearance; Cystatin C; Renal functional reserve; Renal replacement therapy
Substance Nomenclature:
0 (Diuretics)
7LXU5N7ZO5 (Furosemide)
AYI8EX34EU (Creatinine)
Entry Date(s):
Date Created: 20180113 Date Completed: 20200210 Latest Revision: 20200210
Update Code:
20240105
DOI:
10.1007/s00063-017-0400-z
PMID:
29327197
Czasopismo naukowe
Acute kidney injury (AKI) occurs in 30-50% of all intensive care patients. Renal replacement therapy (RRT) has to be initiated in 10-15%. The early in-hospital mortality is about 50%. Up to 20% of all survivors develop chronic kidney disease after intensive care discharge and progress to end-stage kidney disease within the next 10 years. For timely initiation of prophylactic or therapeutic interventions, it is crucial to exactly determine the actual kidney function, i. e., glomerular filtration rate (GFR), and to gain insight into the further development of kidney function. Traditionally, renal function has been estimated using serum levels of creatinine or urea. Unfortunately, both are notoriously unreliable and insensitive in intensive care patients. Cystatin C has fewer non-GFR determinants when compared to creatinine and is more sensitive and accurate to detect early decreases of GFR. At present, new functional tests are discussed, namely the furosemide stress test (FST) and renal functional reserve (RFR). The FST consists of an intravenous infusion of 1.0-1.5 mg/kgBW furosemide to critically ill patients with AKI. An increase in urine output to >100 ml/h is indicative of a GFR >20 ml/min and almost certainly excludes progression to AKI stage III and need for RRT. Estimation of RFR can be made by short-term oral or intravenous administration of a high protein load. A subsequent increase in GFR defines the presence and the magnitude of functional reserve which can be activated. Loss of RFR is an indicator of loss of functioning nephron mass and incomplete recovery following AKI. Both FST and RFR can help to improve diagnosis and care of high-risk patients with acute and chronic kidney disease.

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