Urine Electrolytes in the Intensive Care Unit: From Pathophysiology to Clinical Practice - PubMed
Review
Urine Electrolytes in the Intensive Care Unit: From Pathophysiology to Clinical Practice
Michele Umbrello et al. Anesth Analg. 2020 Nov.
Abstract
Assessment of urine concentrations of sodium, chloride, and potassium is a widely available, rapid, and low-cost diagnostic option for the management of critically ill patients. Urine electrolytes have long been suggested in the diagnostic workup of hypovolemia, kidney injury, and acid-base and electrolyte disturbances. However, due to the wide range of normal reference values and challenges in interpretation, their use is controversial. To clarify their potential role in managing critical patients, we reviewed existing evidence on the use of urine electrolytes for diagnostic and therapeutic evaluation and assessment in critical illness. This review will describe the normal physiology of water and electrolyte excretion, summarize the use of urine electrolytes in hypovolemia, acute kidney injury, acid-base, and electrolyte disorders, and suggest some practical flowcharts for the potential use of urine electrolytes in daily critical care practice.
Similar articles
-
Electrolyte Disturbances in Critically Ill Cancer Patients: An Endocrine Perspective.
Khan MI, Dellinger RP, Waguespack SG. Khan MI, et al. J Intensive Care Med. 2018 Mar;33(3):147-158. doi: 10.1177/0885066617706650. Epub 2017 May 24. J Intensive Care Med. 2018. PMID: 28535742 Review.
-
Assessment of fluids and electrolytes.
Elgart HN. Elgart HN. AACN Clin Issues. 2004 Oct-Dec;15(4):607-21. doi: 10.1097/00044067-200410000-00011. AACN Clin Issues. 2004. PMID: 15586161 Review.
-
The critically ill patient: identification and initial stabilization.
Elnour S, Shankar-Hari M. Elnour S, et al. Br J Hosp Med (Lond). 2011 Sep;72(9):M138-40. doi: 10.12968/hmed.2011.72.sup9.m138. Br J Hosp Med (Lond). 2011. PMID: 22053338 No abstract available.
-
New concepts for bringing urine biochemistry back to clinical practice in the intensive care unit.
Maciel AT; Imed Research Group of Investigators. Maciel AT, et al. Rev Bras Ter Intensiva. 2014 Oct-Dec;26(4):330-2. doi: 10.5935/0103-507X.20140049. Rev Bras Ter Intensiva. 2014. PMID: 25607258 Free PMC article. No abstract available.
-
[Electrolyte imbalances in infancy and childhood].
Konrad M, von Vigier RO. Konrad M, et al. Ther Umsch. 2005 Aug;62(8):557-64. doi: 10.1024/0040-5930.62.8.557. Ther Umsch. 2005. PMID: 16136821 Review. German.
Cited by
-
Abbasi S, Nemati K, Alikiaii B, Saghaei M. Abbasi S, et al. Adv Biomed Res. 2023 Feb 25;12:38. doi: 10.4103/abr.abr_394_21. eCollection 2023. Adv Biomed Res. 2023. PMID: 37057239 Free PMC article.
-
Maciel AT. Maciel AT. Indian J Crit Care Med. 2024 Aug;28(8):729-733. doi: 10.5005/jp-journals-10071-24771. Epub 2024 Jul 31. Indian J Crit Care Med. 2024. PMID: 39239174 Free PMC article.
-
Wu MF, Lee CH, Pai PH, Wang JM. Wu MF, et al. Biomedicines. 2023 Jan 27;11(2):379. doi: 10.3390/biomedicines11020379. Biomedicines. 2023. PMID: 36830916 Free PMC article.
References
-
- Sherman RA, Eisinger RP. The use (and misuse) of urinary sodium and chloride measurements. JAMA. 1982;247:3121–3124.
-
- Harrington JT, Cohen JJ. Measurement of urinary electrolytes - indications and limitations. N Engl J Med. 1975;293:1241–1243.
-
- Palmer BF, Clegg DJ. The use of selected urine chemistries in the diagnosis of kidney disorders. Clin J Am Soc Nephrol. 2019;14:306–316.
-
- Knepper MA, Kwon TH, Nielsen S. Molecular Physiology of Water Balance. Available at: http://dx.doi.org/101056/NEJMra1404726 2015, https://www.nejm.org/doi/pdf/10.1056/NEJMra1404726. Accessed July 24, 2019.
-
- Balanescu S, Kopp P, Gaskill MB, Morgenthaler NG, Schindler C, Rutishauser J. Correlation of plasma copeptin and vasopressin concentrations in hypo-, iso-, and hyperosmolar states. J Clin Endocrinol Metab. 2011;96:1046–1052.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical