The Significance of “Fractional Excretion of Urea” in The Differential Diagnosis of Acute Kidney Injury in Cirrhotic Patients

Abstract

Introduction of acute kidney injury (AKI) was mentioned. Fractional excretion of urea (FEUrea) and its measurement importance was discussed. Concerning diagnostic performance of FEUrea in differentiating the different types of AKI, FEUrea has good diagnostic performance in the differentiation, FEUrea cut-off levels were significantly different in each category of AKI: highest in intrinsic AKI (iAKI) i.e: acute tubular necrosis(ATN), intermediate in prerenal azotemia (PRA) and low in hepatorenal syndrome type1 (HRS1). Furthermore, FEUrea levels in patients with liver cirrhosis and iAKI (ATN) were similar to those with cirrhosis and normal kidney function. FEUrea has not only potentiality to detect AKI but also has the ability to differentiate cause of AKI as shown in the current study that revealed a higher FEUrea cut-off for ATN (>33%) compared to lower cut-off values for PRA (<33% and >21%) and HRS (<21%)