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Background: Fractional excretion of sodium (FENa) is used to differentiate renal from prerenal azotemia. However, many drugs and medical conditions affect the sodium (Na+) handling in the kidney. But the fractional excretion of urea (FEurea) is dependent on passive forces and is less influenced by the diuretic therapy. Objective: Comparison between FENa and FEurea in differentiating renal from prerenal azotemia in circulatory shock, and the effect of diuretics on their handling. Methods: Both FENa and FEurea were measured in 40 patients (pts) with AKI complicating circulatory shock. The pts were divided into 26 pts with prerenal (group-1) and 14 pts with renal azotemia (group-2). Group-1 was subdivided into 12 pts who did not receive diuretics 24 h before the sampling process (group-1a) and 14 pts who received diuretics (group-1b). Results: Compared to patients with renal azotemia (group-2), those with prerenal azotemia (group-1) showed significantly lower FENa (0.99 ± 0.66 and 2.57 ± 1.73, P

Background: The novel urinary neutrophil gelatinase-associated lipocalin (uNGAL) is an early and highly predictive biomarker that is rapidly released in acute kidney injury (AKI). Objective: We investigated the early expression of uNGAL (first 4 days after injury) as a predictor of acute kidney injury complicating circulatory shock. Methods: Urinary-NGAL level was measured in collected urine samples of 45 patients (pts) with circulatory shock, during the first 6 h and after 24 h of onset of shock. Eleven patients responded to fluid infusion ± vasopressors and were considered as a control group. Results: The estimated uNGAL at day 1 and day 2, could predict AKI presenting at days 2, 3 and 4 (P