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Critical Care Research and PracticeVolume 2013 2013, Article ID 721810, 6 pages

Review Article

Department of Critical Care Medicine, University Hospital Carlos Haya, 29018 Malaga, Spain

University of Malaga School of Medicine, Spain

Department of Critical Care Medicine, Santiago Hospital, Vitoria, Spain

Department of Critical Care Medicine, Hospital 12 de Octubre, Madrid, Spain

Department of Critical Care Medicine, Centro Hospitalario de Porto, Portugal

Department of Critical Care Medicine, Hospital Municipal de Necochea, Argentina

Received 12 March 2013; Accepted 12 April 2013

Academic Editor: Stephen M. Pastores

Copyright © 2013 Gemma Seller-Pérez et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Glomerular filtration rate GFR is an accepted measure for assessment of kidney function. For the critically ill patient, creatinine clearance is the method of reference for the estimation of the GFR, although this is often not measured but estimated by equations i.e., Cockroft-Gault or MDRD not well suited for the critically ill patient. Functional evaluation of the kidney rests in serum creatinine Crs that is subjected to multiple external factors, especially relevant overhydration and loss of muscle mass. The laboratory method used introduces variations in Crs, an important fact considering that small increases in Crs have serious repercussion on the prognosis of patients. Efforts directed to stratify the risk of acute kidney injury AKI have crystallized in the RIFLE or AKIN systems, based in sequential changes in Crs or urine flow. These systems have provided a common definition of AKI and, due to their sensitivity, have meant a considerable advantage for the clinical practice but, on the other side, have introduced an uncertainty in clinical research because of potentially overestimating AKI incidence. Another significant drawback is the unavoidable period of time needed before a patient is classified, and this is perhaps the problem to be overcome in the near future.





Author: Gemma Seller-Pérez, Manuel E. Herrera-Gutiérrez, Javier Maynar-Moliner, José A. Sánchez-Izquierdo-Riera, Anibal Marinho, 

Source: https://www.hindawi.com/



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