13 results on '"urea-to-creatinine ratio"'
Search Results
2. The prognostic role of urea-to-creatinine ratio in patients with acute heart failure syndrome: a case–control study
- Author
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Ahmed Refaat Mohamed Sakr, Gamal Fahim Elsayed Gomaa, Salwa Mahmoud El Wasif, and Ahmed Hassan Hosny Eladawy
- Subjects
Urea-to-creatinine ratio ,Acute heart failure ,Acute kidney injury ,Prognosis ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background Recent research has shown that the blood urea/creatinine ratio (BUN/Cr) rather than BUN or Cr alone can predict the prognosis of individuals with acute heart failure (AHF). The objective of this study was to estimate the urea-to creatinine serum ratio (BUN/Cr) in patients with acute decompensated heart failure (ADHF) and correlate the results with patient outcome, length of hospitalization, and mortality. Results Sixty ADHF patients were included and categorized into four groups; Group I: non-AKI with low BUN/Cr (n = 25); Group II: non-AKI with high BUN/Cr (n = 5); Group III: AKI with low BUN/Cr (n = 14); Group IV: AKI with high BUN/Cr (n = 16). Regarding urea and BUN levels, the first reading showed a considerable rise in urea and BUN levels in groups III and IV compared to group 1 and in group IV compared to groups I and III. Similar results were recorded in the second and third readings. Regarding the BUN/Cr ratio, the three readings revealed a significant elevation in group IV compared to groups I and II and in group IV compared to group III. Mortality was significantly higher in group IV compared to group I. Additionally, MACE was significantly more frequent in group IV compared to groups I and III. Multivariable logistic regression analysis revealed that hypertension, creatinine, and BUN were independent predictors of AKI. Conclusions BUN/Cr may predict prognosis in AHF patients since AHF with an elevated BUN/Cr is associated with a higher death rate.
- Published
- 2023
- Full Text
- View/download PDF
3. Clinical implications of admission and follow-up urea-to-creatinine ratio in patients with acute decompensated heart failure
- Author
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Moubarez, Doaa Atef, Fathelbab, Hany Tawfik, Mohammed, El-Sayed Abd- Elhalim, and Elsawy, Ahmed Samir
- Published
- 2024
- Full Text
- View/download PDF
4. The prognostic role of urea-to-creatinine ratio in patients with acute heart failure syndrome: a case–control study.
- Author
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Sakr, Ahmed Refaat Mohamed, Gomaa, Gamal Fahim Elsayed, Wasif, Salwa Mahmoud El, and Eladawy, Ahmed Hassan Hosny
- Abstract
Background: Recent research has shown that the blood urea/creatinine ratio (BUN/Cr) rather than BUN or Cr alone can predict the prognosis of individuals with acute heart failure (AHF). The objective of this study was to estimate the urea-to creatinine serum ratio (BUN/Cr) in patients with acute decompensated heart failure (ADHF) and correlate the results with patient outcome, length of hospitalization, and mortality. Results: Sixty ADHF patients were included and categorized into four groups; Group I: non-AKI with low BUN/Cr (n = 25); Group II: non-AKI with high BUN/Cr (n = 5); Group III: AKI with low BUN/Cr (n = 14); Group IV: AKI with high BUN/Cr (n = 16). Regarding urea and BUN levels, the first reading showed a considerable rise in urea and BUN levels in groups III and IV compared to group 1 and in group IV compared to groups I and III. Similar results were recorded in the second and third readings. Regarding the BUN/Cr ratio, the three readings revealed a significant elevation in group IV compared to groups I and II and in group IV compared to group III. Mortality was significantly higher in group IV compared to group I. Additionally, MACE was significantly more frequent in group IV compared to groups I and III. Multivariable logistic regression analysis revealed that hypertension, creatinine, and BUN were independent predictors of AKI. Conclusions: BUN/Cr may predict prognosis in AHF patients since AHF with an elevated BUN/Cr is associated with a higher death rate. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
5. Elevated Serum Urea-to-Creatinine Ratio and In-Hospital Death in Patients with Hyponatremia Hospitalized for COVID-19.
- Author
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Regolisti, Giuseppe, Rebora, Paola, Occhino, Giuseppe, Lieti, Giulia, Molon, Giulio, Maloberti, Alessandro, Algeri, Michela, Giannattasio, Cristina, Valsecchi, Maria Grazia, and Genovesi, Simonetta
- Subjects
COVID-19 ,HYPONATREMIA ,HOSPITAL patients ,ELEMENTAL diet - Abstract
Hyponatremia is associated with adverse outcomes in hospitalized patients. An elevated value of the serum urea-to-creatinine ratio (UCR) has been proposed as a proxy of hypovolemia. The aim of this study was to investigate the relationship between the UCR and in-hospital death in patients hospitalized with COVID-19 and hyponatremia. We studied 258 patients admitted for COVID-19 between January 2020 and May 2021 with serum sodium at < 135 mmol/L. The primary end-point was all-cause mortality. A 5-unit increase in the serum UCR during hospital stays was associated with an 8% increase in the hazard of all-cause death (HR = 1.08, 95% CI: 1.03–1.14, p = 0.001) after adjusting for potential confounders. In patients with a UCR > 40 at baseline, a > 10 mmol/L increase in serum sodium values within the first week of hospitalization was associated with higher odds of in-hospital death (OR = 2.93, 95% CI: 1.03–8.36, p = 0.044) compared to patients who experienced a < 10 mmol/L change. This was not observed in patients with a UCR < 40. Hypovolemia developing during hospital stays in COVID-19 patients with hyponatremia detected at hospital admission bears an adverse prognostic impact. Moreover, in hypovolemic patients, a > 10 mmol/L increase in serum sodium within the first week of hospital stays may further worsen the in-hospital prognosis. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
6. Elevated Serum Urea-to-Creatinine Ratio and In-Hospital Death in Patients with Hyponatremia Hospitalized for COVID-19
- Author
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Giuseppe Regolisti, Paola Rebora, Giuseppe Occhino, Giulia Lieti, Giulio Molon, Alessandro Maloberti, Michela Algeri, Cristina Giannattasio, Maria Grazia Valsecchi, and Simonetta Genovesi
- Subjects
sodium ,hyponatremia ,urea-to-creatinine ratio ,COVID-19 ,mortality ,intensive care unit ,Biology (General) ,QH301-705.5 - Abstract
Hyponatremia is associated with adverse outcomes in hospitalized patients. An elevated value of the serum urea-to-creatinine ratio (UCR) has been proposed as a proxy of hypovolemia. The aim of this study was to investigate the relationship between the UCR and in-hospital death in patients hospitalized with COVID-19 and hyponatremia. We studied 258 patients admitted for COVID-19 between January 2020 and May 2021 with serum sodium at < 135 mmol/L. The primary end-point was all-cause mortality. A 5-unit increase in the serum UCR during hospital stays was associated with an 8% increase in the hazard of all-cause death (HR = 1.08, 95% CI: 1.03–1.14, p = 0.001) after adjusting for potential confounders. In patients with a UCR > 40 at baseline, a > 10 mmol/L increase in serum sodium values within the first week of hospitalization was associated with higher odds of in-hospital death (OR = 2.93, 95% CI: 1.03–8.36, p = 0.044) compared to patients who experienced a < 10 mmol/L change. This was not observed in patients with a UCR < 40. Hypovolemia developing during hospital stays in COVID-19 patients with hyponatremia detected at hospital admission bears an adverse prognostic impact. Moreover, in hypovolemic patients, a > 10 mmol/L increase in serum sodium within the first week of hospital stays may further worsen the in-hospital prognosis.
- Published
- 2023
- Full Text
- View/download PDF
7. REDOX REDUX? Glutamine, Catabolism, and the Urea-to-Creatinine Ratio as a Novel Nutritional Metric.
- Author
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Kim, Jennie S. and Martin, Matthew J.
- Subjects
- *
ENTERAL feeding , *GLUTAMINE , *CATABOLISM , *SOMATOMEDIN C - Abstract
This study does an excellent job continuing to build support for the use of UCR in patients with prolonged critical illness and multiple organ failure. They analyzed 1,173 patients admitted to a single level 1 trauma-ICU and noted a greater UCR rise in patients with persistent critical illness compared with those discharged from the ICU before day 10. As mentioned above, the findings of harm with glutamine in the ICU in both the REDOXS and METAPLUS Trials were limited to patients with multiple organ failure or to the medical cohort in a mixed medical-surgical patient population. [Extracted from the article]
- Published
- 2022
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- View/download PDF
8. Short-Term Variations in Neutrophil-to-Lymphocyte and Urea-to-Creatinine Ratios Anticipate Intensive Care Unit Admission of COVID-19 Patients in the Emergency Department
- Author
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Antonio Giovanni Solimando, Nicola Susca, Paola Borrelli, Marcella Prete, Gianfranco Lauletta, Fabrizio Pappagallo, Roberta Buono, Gianfranco Inglese, Bianca Maria Forina, Donatello Bochicchio, Martina Capobianco, Valeria Carrieri, Sebastiano Cicco, Patrizia Leone, Nicola Silvestris, Annalisa Saracino, Roberto Ria, Vito Procacci, Giovanni Migliore, Angelo Vacca, and Vito Racanelli
- Subjects
COVID-19 ,disease severity ,intensive care unit ,neutrophil-to-lymphocyte ratio ,urea-to-creatinine ratio ,Medicine (General) ,R5-920 - Abstract
Background: Timely assessment of COVID-19 severity is crucial for the rapid provision of appropriate treatments. Definitive criteria for the early identification of severe COVID-19 cases that require intensive care unit admission are lacking.Methods: This was a single-center, retrospective case-control study of 95 consecutive adults admitted to the intensive care unit (cases) or a medical ward (controls) for laboratory-confirmed COVID-19. Clinical data were collected and changes in laboratory test results were calculated between presentation at the emergency department and admission. Univariate and multivariable logistic regression was performed to calculate odds ratios for intensive care unit admission according to changes in laboratory variables.Results: Of the 95 adults with COVID-19, 25 were admitted to intensive care and 70 to a medical ward after a median 6 h stay in the emergency department. During this interval, neutrophil counts increased in cases and decreased in controls (median, 934 vs. −295 × 106/L; P = 0.006), while lymphocyte counts decreased in cases and increased in controls (median, −184 vs. 109 × 106/L; P < 0.001). In cases, the neutrophil-to-lymphocyte ratio increased 6-fold and the urea-to-creatinine ratio increased 20-fold during the emergency department stay, but these ratios did not change in controls (P < 0.001 for both comparisons). By multivariable logistic regression, short-term increases in the neutrophil-to-lymphocyte ratio (OR = 1.43; 95% CI, 1.16–1.76) and urea-to-creatinine ratio (OR = 1.72; 95% CI, 1.20–2.66) were independent predictors of intensive care unit admission.Conclusion: Short-time changes in neutrophil-to-lymphocyte ratio and urea-to-creatinine ratio emerged as stand-alone parameters able to identify patients with aggressive disease at an early stage.
- Published
- 2021
- Full Text
- View/download PDF
9. Elevated Serum Urea-to-Creatinine Ratio and In-Hospital Death in Patients with Hyponatremia Hospitalized for COVID-19
- Author
-
Regolisti, G, Rebora, P, Occhino, G, Lieti, G, Molon, G, Maloberti, A, Algeri, M, Giannattasio, C, Valsecchi, M, Genovesi, S, Regolisti, Giuseppe, Rebora, Paola, Occhino, Giuseppe, Lieti, Giulia, Molon, Giulio, Maloberti, Alessandro, Algeri, Michela, Giannattasio, Cristina, Valsecchi, Maria Grazia, Genovesi, Simonetta, Regolisti, G, Rebora, P, Occhino, G, Lieti, G, Molon, G, Maloberti, A, Algeri, M, Giannattasio, C, Valsecchi, M, Genovesi, S, Regolisti, Giuseppe, Rebora, Paola, Occhino, Giuseppe, Lieti, Giulia, Molon, Giulio, Maloberti, Alessandro, Algeri, Michela, Giannattasio, Cristina, Valsecchi, Maria Grazia, and Genovesi, Simonetta
- Abstract
Hyponatremia is associated with adverse outcomes in hospitalized patients. An elevated value of the serum urea-to-creatinine ratio (UCR) has been proposed as a proxy of hypovolemia. The aim of this study was to investigate the relationship between the UCR and in-hospital death in patients hospitalized with COVID-19 and hyponatremia. We studied 258 patients admitted for COVID-19 between January 2020 and May 2021 with serum sodium at < 135 mmol/L. The primary end-point was all-cause mortality. A 5-unit increase in the serum UCR during hospital stays was associated with an 8% increase in the hazard of all-cause death (HR = 1.08, 95% CI: 1.03–1.14, p = 0.001) after adjusting for potential confounders. In patients with a UCR > 40 at baseline, a > 10 mmol/L increase in serum sodium values within the first week of hospitalization was associated with higher odds of in-hospital death (OR = 2.93, 95% CI: 1.03–8.36, p = 0.044) compared to patients who experienced a < 10 mmol/L change. This was not observed in patients with a UCR < 40. Hypovolemia developing during hospital stays in COVID-19 patients with hyponatremia detected at hospital admission bears an adverse prognostic impact. Moreover, in hypovolemic patients, a > 10 mmol/L increase in serum sodium within the first week of hospital stays may further worsen the in-hospital prognosis.
- Published
- 2023
10. ICU-Acquired Hypernatremia Is Associated with Persistent Inflammation, Immunosuppression and Catabolism Syndrome
- Author
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Christopher Rugg, Mathias Ströhle, Benedikt Treml, Mirjam Bachler, Stefan Schmid, and Janett Kreutziger
- Subjects
hypernatremia ,PICS ,catabolism ,inflammation ,urea-to-creatinine ratio ,Medicine - Abstract
Developing hypernatremia while on intensive care unit (ICU) is a common problem with various undesirable effects. A link to persistent inflammation, immunosuppression and catabolism syndrome (PICS) can be established in two ways. On the one hand, hypernatremia can lead to inflammation and catabolism via hyperosmolar cell stress, and on the other, profound catabolism can lead to hypernatremia via urea-induced osmotic diuresis. In this retrospective single-center study, we examined 115 patients with prolonged ICU stays (≥14 days) and sufficient renal function. Depending on their serum sodium concentrations between ICU day 7 and 21, allocation to a hypernatremic (high) and a nonhypernatremic group (low) took place. Distinct signs of PICS were detectable within the complete cohort. Thirty-three of them (28.7%) suffered from ICU-acquired hypernatremia, which was associated with explicitly higher signs of inflammation and ongoing catabolism as well as a prolonged ICU length of stay. Catabolism was discriminated better by the urea generation rate and the urea-to-creatinine ratio than by serum albumin concentration. An assignable cause for hypernatremia was the urea-induced osmotic diuresis. When dealing with ICU patients requiring prolonged treatment, hypernatremia should at least trigger thoughts on PICS as a contributing factor. In this regard, the urea-to-creatinine ratio is an easily accessible biomarker for catabolism.
- Published
- 2020
- Full Text
- View/download PDF
11. The Urea-to-Creatinine Ratio Is Predictive of Worsening Kidney Function in Ambulatory Heart Failure Patients.
- Author
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Sood, Manish M., Saeed, Mahwash, Lim, Vincent, Cordova, Francisco, Komenda, Paul, Malik, Amrit, Rigatto, Claudio, Shafer, Leigh Anne, Tangri, Navdeep, Tappia, Paramjit S., and Zieroth, Shelley
- Abstract
Background Changes in kidney function in heart failure patients convey important prognostic information. We investigated the association of the urea-to-creatinine (BUN/Cr) ratio, the fractional excretion of urea (FeUr), and the fractional excretion of sodium (FeNa) and subsequent declines in kidney function in ambulatory heart failure patients. Methods and Results We prospectively enrolled adult patients with ejection fraction <40% at a multidisciplinary heart failure clinic and measured serial measurements of laboratory values from September 2008 to July 2011. The study outcome was changes in the estimated glomerular filtration rate (eGFR). In 138 patients contributing 10,350 patient-hours of follow-up, we found that participants with a decline of >25% in eGFR had higher mean BUN/Cr ratio (0.110 ± 0.043 vs 0.086 ± 0.026; P = .02) and no difference in the FeNa (1.81 vs 1.43; P = .2) or FeUr (32.3 vs 37.2; P = .9) compared with those with no change. There was an association of BUN/Cr ratio with the rate of change of eGFR (coefficient −25.67, 95% confidence interval [CI] −10.99 to −40.35; P < .0001). The BUN/Cr ratio was an independent predictor of eGFR drop >25% (odds ratio 1.19, 95% CI 1.07–1.32) and improved model discrimination (c-statistic increased from 0.624 to 0.693) and reclassification (net reclassification index 11.38% [ P < .0001], integrated discrimination improvement 5.24% [ P = .02]). Conclusions The BUN/Cr ratio is associated with worsening kidney function and adds incremental risk prediction information relative to traditional predictive measures in outpatients with heart failure at risk for worsening kidney disease. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
12. ICU-Acquired Hypernatremia Is Associated with Persistent Inflammation, Immunosuppression and Catabolism Syndrome.
- Author
-
Rugg, Christopher, Ströhle, Mathias, Treml, Benedikt, Bachler, Mirjam, Schmid, Stefan, and Kreutziger, Janett
- Subjects
- *
HYPERNATREMIA , *METABOLISM , *INTENSIVE care units , *IMMUNOSUPPRESSION , *SERUM albumin , *INFLAMMATION - Abstract
Developing hypernatremia while on intensive care unit (ICU) is a common problem with various undesirable effects. A link to persistent inflammation, immunosuppression and catabolism syndrome (PICS) can be established in two ways. On the one hand, hypernatremia can lead to inflammation and catabolism via hyperosmolar cell stress, and on the other, profound catabolism can lead to hypernatremia via urea-induced osmotic diuresis. In this retrospective single-center study, we examined 115 patients with prolonged ICU stays (≥14 days) and sufficient renal function. Depending on their serum sodium concentrations between ICU day 7 and 21, allocation to a hypernatremic (high) and a nonhypernatremic group (low) took place. Distinct signs of PICS were detectable within the complete cohort. Thirty-three of them (28.7%) suffered from ICU-acquired hypernatremia, which was associated with explicitly higher signs of inflammation and ongoing catabolism as well as a prolonged ICU length of stay. Catabolism was discriminated better by the urea generation rate and the urea-to-creatinine ratio than by serum albumin concentration. An assignable cause for hypernatremia was the urea-induced osmotic diuresis. When dealing with ICU patients requiring prolonged treatment, hypernatremia should at least trigger thoughts on PICS as a contributing factor. In this regard, the urea-to-creatinine ratio is an easily accessible biomarker for catabolism. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
13. Short-Term Variations in Neutrophil-to-Lymphocyte and Urea-to-Creatinine Ratios Anticipate Intensive Care Unit Admission of COVID-19 Patients in the Emergency Department.
- Author
-
Solimando AG, Susca N, Borrelli P, Prete M, Lauletta G, Pappagallo F, Buono R, Inglese G, Forina BM, Bochicchio D, Capobianco M, Carrieri V, Cicco S, Leone P, Silvestris N, Saracino A, Ria R, Procacci V, Migliore G, Vacca A, and Racanelli V
- Abstract
Background: Timely assessment of COVID-19 severity is crucial for the rapid provision of appropriate treatments. Definitive criteria for the early identification of severe COVID-19 cases that require intensive care unit admission are lacking. Methods: This was a single-center, retrospective case-control study of 95 consecutive adults admitted to the intensive care unit (cases) or a medical ward (controls) for laboratory-confirmed COVID-19. Clinical data were collected and changes in laboratory test results were calculated between presentation at the emergency department and admission. Univariate and multivariable logistic regression was performed to calculate odds ratios for intensive care unit admission according to changes in laboratory variables. Results: Of the 95 adults with COVID-19, 25 were admitted to intensive care and 70 to a medical ward after a median 6 h stay in the emergency department. During this interval, neutrophil counts increased in cases and decreased in controls (median, 934 vs. -295 × 10
6 /L; P = 0.006), while lymphocyte counts decreased in cases and increased in controls (median, -184 vs. 109 × 106 /L; P < 0.001). In cases, the neutrophil-to-lymphocyte ratio increased 6-fold and the urea-to-creatinine ratio increased 20-fold during the emergency department stay, but these ratios did not change in controls ( P < 0.001 for both comparisons). By multivariable logistic regression, short-term increases in the neutrophil-to-lymphocyte ratio (OR = 1.43; 95% CI, 1.16-1.76) and urea-to-creatinine ratio (OR = 1.72; 95% CI, 1.20-2.66) were independent predictors of intensive care unit admission. Conclusion: Short-time changes in neutrophil-to-lymphocyte ratio and urea-to-creatinine ratio emerged as stand-alone parameters able to identify patients with aggressive disease at an early stage., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Solimando, Susca, Borrelli, Prete, Lauletta, Pappagallo, Buono, Inglese, Forina, Bochicchio, Capobianco, Carrieri, Cicco, Leone, Silvestris, Saracino, Ria, Procacci, Migliore, Vacca and Racanelli.)- Published
- 2021
- Full Text
- View/download PDF
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