Toward the optimal clinical use of the fraction excretion of solutes in oliguric azotemia

被引:17
|
作者
Diskin, Charles J. [1 ]
Stokes, Thomas J. [1 ]
Dansby, Linda M. [1 ]
Radcliff, Lautrec [1 ]
Carter, Thomas B. [1 ]
机构
[1] Auburn Univ, Hypertens Nephrol Dialysis & Transplantat Clin, Opelika, AL 36801 USA
关键词
azotemia; renal failure; diagnosis; solute transport; renal physiology; ACUTE-RENAL-FAILURE; URIC-ACID METABOLISM; ACUTE KIDNEY INJURY; B UREA TRANSPORTER; LITHIUM REABSORPTION; DIFFERENTIAL-DIAGNOSIS; SODIUM-REABSORPTION; ELECTROLYTE EXCRETION; URINARY BIOCHEMISTRY; NATRIURETIC PEPTIDE;
D O I
10.3109/0886022X.2010.517353
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
While the fractional excretion of solutes have long been considered excellent research tools to investigate tubular physiology, their clinical use has become common over the last 40 years in the diagnoses of many disorders; however, none have reached the clinical utility of the fractional excretion of sodium in the ability to distinguish pre-renal azotemia from acute tubular necrosis. Nevertheless, there are many drugs and medical conditions that interfere with that utility and recently other solutes, including urea, uric acid and lithium, have been recently investigated to improve the diagnostic ability in clinical situations where the fractional excretion of sodium is known to be unreliable. We review the tubular physiology of these solutes and show how the differences in tubular physiology might be exploited to develop a strategy for their optimal clinical use.
引用
收藏
页码:1245 / 1254
页数:10
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