- Basic science and research
-
The Role of Oliguria and the Absence of Fluid Administration and Balance Information in Illness Severity Scores
-
Neil J. Glassford, Rinaldo Bellomo
-
Korean J Crit Care Med. 2017;32(2):106-123. Published online May 31, 2017
-
DOI: https://doi.org/10.4266/kjccm.2017.00192
-
-
13,440
View
-
324
Download
-
4
Web of Science
-
4
Crossref
-
Abstract
PDF
- Urinary examination has formed part of patient assessment since the earliest days of medicine. Current definitions of oliguria are essentially arbitrary, but duration and intensity of oliguria have been associated with an increased risk of mortality, and this risk is not completely attributable to the development of concomitant acute kidney injury (AKI) as defined by changes in serum creatinine concentration. The increased risk of death associated with the development of AKI itself may be modified by directly or indirectly by progressive fluid accumulation, due to reduced elimination and increased fluid administration. None of the currently extant major illness severity scoring systems or outcome prediction models use modern definitions of AKI or oliguria, or any values representative of fluid volumes variables. Even if a direct relationship with mortality is not observed, then it is possible that fluid balance or fluid volume variables mediate the relationship between illness severity and mortality in the renal and respiratory physiological domains. Fluid administration and fluid balance may then be an important, easily modifiable therapeutic target for future investigation. These relationships require exploration in large datasets before being prospectively validated in groups of critically ill patients from differing jurisdictions to improve prognostication and mortality prediction.
-
Citations
Citations to this article as recorded by
- Management of oliguria
Marlies Ostermann, Andrew D. Shaw, Michael Joannidis Intensive Care Medicine.2023; 49(1): 103. CrossRef - Nomenclature and diagnostic criteria for acute kidney injury – 2020 consensus of the Taiwan AKI-task force
Shao-Yu Yang, Terry Ting-Yu Chiou, Chih-Chung Shiao, Hugo You-Hsien Lin, Ming-Jen Chan, Che-Hsiung Wu, Chiao-Yin Sun, Wei-Jie Wang, Yen-Ta Huang, Vin-Cent Wu, Yung-Chang Chen, Ji-Tsung Fang, Shang-Jyh Hwang, Heng-Chih Pan Journal of the Formosan Medical Association.2022; 121(4): 749. CrossRef - Haemodynamic frailty – A risk factor for acute kidney injury in the elderly
Neil G. Docherty, Christian Delles, Patrick D’Haese, Anita T. Layton, Carlos Martínez-Salgado, Benjamin A. Vervaet, Francisco J. López-Hernández Ageing Research Reviews.2021; 70: 101408. CrossRef - Does Fluid Type and Amount Affect Kidney Function in Critical Illness?
Neil J. Glassford, Rinaldo Bellomo Critical Care Clinics.2018; 34(2): 279. CrossRef
|