Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành hóa học dành cho các bạn yêu hóa học tham khảo đề tài: Understanding urine output in critically ill patients | Legrand and Payen Annals of Intensive Care 2011 1 13 http content 1 1 13 Ù Annals of Intensive Care a SpringerOpen Journal REVIEW Open Access Understanding urine output in critically ill patients Matthieu Legrand and Didier Payen Abstract Urine output often is used as a marker of acute kidney injury but also to guide fluid resuscitation in critically ill patients. Although decrease of urine output may be associated to a decrease of glomerular filtration rate due to decrease of renal blood flow or renal perfusion pressure neurohormonal factors and functional changes may influence diuresis and natriuresis in critically ill patients. The purpose of this review is to discuss the mechanisms of diuresis regulation which may help to interpret the urine output in critically ill patients and the appropriate treatment to be initiated in case of changes in urine output. Introduction Acute renal failure or acute kidney injury AKI is defined by an acute decline of glomerular filtration rate GFR . Occurrence of AKI is associated with substantial in-hospital mortality exceeding 50 when AKI is part of a multiple organ failure syndrome 1 2 . Therefore early recognition of AKI better understanding of its pathogenesis and development of preventing strategies appear to be potential areas of improvement of patient s prognosis. The decrease of glomerular filtration rate and urine output in response to a decrease of renal blood flow is classically referred as pre-renal azotemia which can evolve into structural damage if renal hypoperfusion persists. In this line urine output often is used as a marker of AKI but also to guide fluid resuscitation in critically ill patients. However both the contribution of renal hypoperfusion to AKI and the genuine definition of pre-renal and intra-renal azotemia have been challenged by several authors 3-5 . The recent international consensus conference on acute renal failure therefore recommended the term acute kidney .
