Diagnostic performance of fractional excretion of urea in the evaluation of critically ill patients with acute kidney injury: a multicenter cohort study

Darmon, Michael; Vincent, Francois; Dellamonica, Jean; Schortgen, Frederique; Gonzalez, Frederic; Das, Vincent; Zeni, Fabrice; Brochard, Laurent; Bernardin, Gilles; Cohen, Yves; Schlemmer, Benoit

doi:10.1186/cc10327

Critical Care

Table 2 Performance of usual urinary markers for detecting patients with persistent AKI among patients with AKI, with the usual and optimal (*) cutoff values^a

From: Diagnostic performance of fractional excretion of urea in the evaluation of critically ill patients with acute kidney injury: a multicenter cohort study

Patient groups	FeNa > 1%	FeNa* > 0.58%	FeUrea < 35%	FeUrea* < 37%	U/P urea < 10	U/P urea* < 12	U/P creat < 20	U/P creat* < 12
All patients with AKI (n = 136; persistent AKI prevalence = 60.3%)
Sensitivity (%)	0.48	0.63	0.63	0.66	0.74	0.66	0.79	0.59
Specificity (%)	0.7	0.61	0.54	0.53	0.57	0.66	0.39	0.59
Positive predictive value	0.71	0.71	0.67	0.68	0.72	0.74	0.66	0.68
Negative predictive value	0.47	0.47	0.47	0.51	0.59	0.56	0.55	0.48
Positive likelihood ratio	1.6	1.61	1.37	1.4	1.72	1.94	1.3	1.44
Negative likelihood ratio	0.74	0.61	0.68	0.64	0.45	0.52	0.54	0.69
Younden's index	0.18	0.24	0.17	0.19	0.31	0.32	0.18	0.18
ROC AUC	0.62 (0.52 to 0.72)		0.59 (0.49 to 0.70)		0.71 (0.62 to 0.80)		0.62 (0.53 to 0.72)
Patients taking diuretics (n = 50; persistent AKI prevalence = 64%)
Sensitivity (%)	0.75	0.62	0.61	0.61	0.72	0.61	0.78	0.89
Specificity (%)	0.56	0.56	0.47	0.59	0.69	0.75	0.5	0.38
Positive predictive value	0.71	0.71	0.67	0.68	0.81	0.81	0.73	0.72
Negative predictive value	0.47	0.47	0.49	0.51	0.58	0.52	0.56	0.66
Positive likelihood ratio	1.7	1.41	1.15	1.49	2.32	2.44	1.56	1.44
Negative likelihood ratio	0.47	0.68	0.83	0.66	0.41	0.52	0.44	0.29
Younden's index	0.31	0.18	0.08	0.2	0.41	0.36	0.28	0.27
ROC AUC	0.69 (0.54 to 0.81)		0.58 (0.41 to 0.75)		0.82 (0.70 to 0.94)		0.71 (0.56 to 0.86)
Patients with sepsis (n = 94; persistent AKI prevalence = 65%)
Sensitivity (%)	0.5	0.65	0.63	0.63	0.8	0.67	0.87	0.93
Specificity (%)	0.86	0.56	0.52	0.57	0.63	0.63	0.42	0.37
Positive predictive value	0.87	0.73	0.71	0.73	0.8	0.63	0.74	0.73
Negative predictive value	0.48	0.46	0.43	0.45	0.63	0.51	0.63	0.74
Positive likelihood ratio	3.57	1.48	1.31	1.47	2.1	1.81	1.5	1.48
Negative likelihood ratio	0.58	0.63	0.71	0.65	0.32	0.52	0.31	0.19
Younden's index	0.36	0.19	0.15	0.2	0.43	0.3	0.29	0.3
ROC AUC	0.67 (0.56 to 0.79)		0.56 (0.43 to 0.68)		0.71 (0.60 to 0.82)		0.65 (0.53 to 0.77)

^aAKI: acute kidney injury; ROC: receiver operating characteristic; AUC: area under the curve.

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