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Fractional Excretion of Uric Acid as a Predictor for Saline Responsiveness in Long-Term Kidney Transplant Patients

Title
Fractional Excretion of Uric Acid as a Predictor for Saline Responsiveness in Long-Term Kidney Transplant Patients
Author
김근호
Keywords
Acute kidney injury; Kidney transplantation; Tubular transport; Uric acid
Issue Date
2012-08
Publisher
S. Karger AG
Citation
Kidney & blood pressure research, 2012, 35(6), P.627-633
Abstract
Background/Aims: Subclinical hypovolemia may contribute to allograft dysfunction in long-term kidney transplant (KT) patients. In order to predict responsiveness to saline hydration, indices for tubular transport were investigated. Methods: Fifty-four clinically euvolemic long-term KT patients with recently aggravated azotemia were given intravenous hydration as follows: 0.9% saline 5 ml/kg over 1 h, followed by 0.9% saline 1 ml/kg/h over 12 h and 1 liter of 0.45% saline over the next 24 h. Serum and urine data were collected and analyzed to assess 0000005E responses. Results: In all patients, saline hydration relieved azotemia, as shown by blood ure 00000AEC a nitrogen (46.9 +/- 17.2 vs. 39.3 +/- 15.4 mg/dl; p < 0.01) and serum creatinine levels (2.9 +/- 1.1 vs. 2.5 +/- 1.1 mg/dl; p < 0.01) on day 0 versus day 2. In 38 patients, serum creatinine did not increase in the following month (70% responders). Compared with the nonresponders, the responders had a higher urine-to-plasma creatinine ratio and lower fractional excretion of sodium, uric acid and urea at admission. Multivariate logistic regression analysis revealed that responsiveness to saline hydration was independently associated with lower fractional excretion of uric acid. Conclusion: Subclinical hypovolemia should be considered in long-term KT patients with azotemia of unexplainable causes. Fractional excretion of uric acid may predict responsiveness to saline hydration.
URI
http://www.karger.com/Article/FullText/341124http://hdl.handle.net/20.500.11754/48773
ISSN
1420-4096
DOI
10.1159/000341124
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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