THE FRACTIONAL EXCRETION OF UREA - A NEW DIAGNOSTIC-TEST FOR ACUTE RENAL-ALLOGRAFT REJECTION

被引：8

作者：

COREY, HE

GREIFER, I

GREENSTEIN, SM

TELLIS, V

SPITZER, A

机构：

[1] Department of Pediatrics, Albert Einstein College of Medicine/Montefiore Medical Center, New York

[2] Department of Surgery, Albert Einstein College of Medicine/Montefiore Medical Center, New York

来源：

PEDIATRIC NEPHROLOGY | 1993年 / 7卷 / 03期

关键词：

TRANSPLANTATION; REJECTION; FRACTIONAL EXCRETION; UREA;

D O I：

10.1007/BF00853217

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

Fractional excretion of sodium (FE(Na)) has been used in the diagnosis of acute renal allograft failure on the assumption that poor allograft perfusion should result in a low FE(Na). However, many patients receive medications which affect the active transport of Na+ and thus FE(Na). In contrast, the fractional excretion of urea (FE(urea)) is mostly dependent on passive forces and is therefore less influenced by drug therapy. To test the hypothesis that FE(urea) might be more useful than FE(Na) in evaluating graft failure, we compared FE(urea) with FE(Na) during 79 episodes of acute renal allograft dysfunction due to acute rejection (AR), cyclosporine nephrotoxicity (CsA-Nx), viral infection, or bacterial infection in 32 children and young adults with renal transplants. There was no significant difference between groups in FE(Na). However, FE(urea) was significantly lower (P <0.05) in patients with CsA-Nx (32.6 +/- 1.9%) and viral infection (32.9 +/- 3.2%) than those with AR (45.1 +/- 1.7%) or bacterial infection (38.9 +/- 2.5%). FE(urea) was <35% in 20 of 28 (71.4%) episodes of CsA-Nx and 8 of 11 (72.2%) of viral infection, but only 5 of 36 (13.9%) of AR (P <0.05). FE(urea) was also measured during stable graft function, 7-14 days prior to allograft dysfunction. CsA-Nx was associated with a 30.5 +/- 8.3% decrease in FE(urea). FE(urea) did not change in patients with AR. Based on these findings, we present an algorithm to aid in the differential diagnosis of acute renal allograft failure.

引用

页码：268 / 272

页数：5

共 27 条

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