title: Association of oliguria with the development of acute kidney injury in the critically ill.
abstract: Urine output (UO) criterion may increase the sensitivity of the definition of acute kidney injury (AKI). We determined whether the empirically derived definition for oliguria(<0.5 ml/kg/h) is independently associated with adverse outcome. Data analysis included hourly recorded UO from the prospective, multicenter FINNAKI study conducted in 16 Finnish intensive care units. Confounder-adjusted association of oliguria of different severity and duration primarily with the development of AKI defined by creatinine criterion (Cr-AKI) or renal replacement therapy(RRT) was assessed. Secondarily, we determined the association of oliguria with 90-day mortality. Of the 1966 patients analyzed for the development of AKI, 454 (23.1%) reached this endpoint. Within this AKI cohort, 312 (68.7%)developed Cr-AKI, 21 (4.6%) commenced RRT without Cr-AKI, and 121 (26.7%) commenced RRT with Cr-AKI. Episodes of severe oliguria (<0.1 ml/kg/h) for more than 3 h were independently associated with the development of Cr-AKI or RRT. The shortest periods of consecutive oliguria independently associated with an increased risk for 90-day mortality were 6–12 h of oliguria from 0.3 to <0.5 ml/kg/h, over 6 h of oliguria from 0.1 to <0.3 ml/kg/h, and severe oliguria lasting over 3 h.Thus, our findings underlie the importance of hourly UO measurements.
authors.forename: Suvi T
authors.initials: ST
authors.lastname: Vaara
authors.forename: Ilkka
authors.initials: I
authors.lastname: Parviainen
authors.forename: Ville
authors.initials: V
authors.lastname: Pettilä
authors.forename: Sara
authors.initials: S
authors.lastname: Nisula
authors.forename: Outi
authors.initials: O
authors.lastname: Inkinen
authors.forename: Ari
authors.initials: A
authors.lastname: Uusaro
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality*; D000368:Aged; D003404:Creatinine / Q000097:blood; D016638:Critical Illness; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009846:Oliguria / Q000652:urine*; D011446:Prospective Studies; D017582:Renal Replacement Therapy; D012720:Severity of Illness Index; D013997:Time Factors; D014556:Urine
chemical_list: D003404:Creatinine