Meta AnalysisID 2029
评价肌酐与尿量随时间变化在危重患者急性肾损伤中的诊断性能：系统评价
CRD42019118840
Which of the criteria for acute kidney injury: urinary output versus creatinine level, has better diagnostic performance in critically ill patients? P - critical ill patient with acute kidney injury I - creatinine C - ur
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Record Fields
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- Meta Analysis Id
- 2029
- Evidence Id
- 10587
- Core Evidence Id
- 10587
- Source Meta Analysis Id
- 1972
- Herb2 Meta Analysis Id
- HBMA001972
- Crd Id
- CRD42019118840
- Title
- Evaluation of the diagnostic performance of creatinine compared with urine output in function of time, in acute kidney injury in critically ill patients. Systematic review
- Review Question
- Which of the criteria for acute kidney injury: urinary output versus creatinine level, has better diagnostic performance in critically ill patients? P - critical ill patient with acute kidney injury I - creatinine C - urine output O - diagnostic performance
- Study Type Included
- Being a systematic review of diagnostic tests, the included studies must contain the data showing the true positives, false negatives, sensitivity and specificity measures, or data that allow the calculation of the same.
- Condition Being Studied
- Acute kidney injury (AKI) is a syndrome characterized by a rapid decline in renal function that it is reversible. It is a frequent pathology that affects 13.3 million people in the world: acquired in community, hospitalized and especially in the intensive care unit (ICU). Despite being preventable and treatable, globally reported 1 in 5 adults and 1 in 3 children during hospitalization, more than 85% of these are contributed by developing countries. The incidence of AKI varies between 26.6-35.4% in hospitalized patients, reaching 38-50% in critical patients in the intensive care unit (ICU). With a great impact, because this condition increases the morbidity 3 times and mortality up to 7 times and even up to 10 times in the degrees with greater severity, with a percentage of mortality as high as up to 83%. The diagnosis is made with the use of creatinine and urine output and it has been clearly documented that when both values are altered the prognosis is worse. However, there is no clarity about the comparison between these in terms of outcomes such as diagnostic opportunity and mortality.
- Participant
- Criteria of inclusion of the studies • studies that include patients older than 15 years. • studies that include patients of both sexes (male - female) • studies that include patients with acute kidney injury. • studies that report urine output and creatinine Exclusion criteria for studies • studies that include patients with pre-existence advanced chronic kidney disease on dialysis. • studies with patients with kidney transplant. • studies that include pregnant women. • studies without data to estimate diagnostic performance
- Animal
- Human Disease Modelled
- Intervention
- Index text Urinary output as a comparative test is found in the definition by consensus of experts. It has been maintained over the years because it was granted advantages such as: not needing a baseline value, being an earlier indicator, not being affected by multiple variables as happens to creatinine. Others argue that in critically ill patients it is a guide for fluid management and its reduction is associated to multiple factors such as poor perfusion, functional changes and even neuro-humoral factors and that in 100% of cases there is no relationship between the oliguria with the decrease in GFR, because, on the contrary, in those with severe tubular dysfunction, there may be polyuria or increased diuresis, with a clear alteration of the GFR and not be perceived.
- Comparator Control
- Standar Text Creatinine is derived from muscle creatinine, with a molecular weight of 113 Da. Despite not being the ideal biomarker, it has been used for many years as the way to estimate GFR; it has been used as the current gold standard for the definition of Acute Kidney Injury (AKI). It is freely filtered in the glomerulus but secreted 10-20% by the proximal tubule, which during acute renal injury can rise up to 50%, for which its values are highly affected; not only for its urinary clearance, but for the rate of production and even the volume of distribution that is very variable.
- Main Outcome
- Our primary objective is to measure the diagnostic capacity of urinary output compared to creatinine for acute kidney injury in critically ill patients. We intend to describe the sensitivity and specificity of creatinine and urine output for the diagnosis of AKI and compare performance.
- Outcome Measure
- Additional Outcome
- - Describe the sensitivity and specificity of creatinine and urine output for the diagnosis of AKI - Describe the relationship between mortality and AKI according to the diagnosis made by urinary output compared to creatinine. - If it is possible, describe the relationship between AKI by production of urine or creatinine with days of hospitalization.
- Study Method
- Diagnostic, Systematic review
- Keyword
- Acute Kidney Injury; Creatinine; Critical Illness; Humans
- Contact
- Organisational Affiliation
- Funding Source
- Other Selection Criteria
- Final Publication
- Same Topic Review
- Published Protocol
- Review Type
- Language
- English
- Country
- Review Stage
- First Submission Date
- Registration Date
- Anticipated Start Date
- Anticipated Completion Date
- Title Cn
- 评价肌酐与尿量随时间变化在危重患者急性肾损伤中的诊断性能：系统评价
- Title En
- Evaluation of the diagnostic performance of creatinine compared with urine output in function of time, in acute kidney injury in critically ill patients. Systematic review
- Bilingual Status
- complete