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Breaking old and new paradigms regarding urinary sodium in acute kidney injury diagnosis and management

机译：急性肾脏损伤诊断和治疗中有关尿钠的新旧范例的突破

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Urinary sodium (NaU) is one of the oldest parameters used in the evaluation of azotemia and oliguria. Over the past years, however, it has progressively been considered as obsolete and useless, especially in sepsis. It is common sense that NaU frequently does not correlate well with global renal blood flow. If intrarenal microcirculatory changes are more important in acute kidney injury (AKI) than changes in global renal blood flow, we speculate that decreases in NaU may be viewed as a possible marker of microcirculatory impairment in the kidneys. Recent findings by our group (some not yet published) in which sodium retentive capacity is preserved until advanced stages of AKI and the observation of decreases in NaU preceding increases in creatinine bring us to conclude that the new paradigm of abolishing NaU consideration from daily approaches to managing patients at risk for AKI must be reevaluated.
机译：尿钠（NaU）是用于评估氮质血症和少尿的最古老的参数之一。然而，在过去的几年中，尤其是在败血症中，它已被逐渐认为是过时且无用的。众所周知，NaU经常与总体肾血流量没有很好的相关性。如果在急性肾损伤（AKI）中肾内微循环改变比整体肾血流改变更重要，我们推测NaU降低可能被视为肾脏微循环障碍的可能标志。我们小组最近的发现（一些尚未发表）表明，钠保持力一直保持到AKI的晚期，并且观察到肌酐增加之前NaU降低，这使我们得出结论，从日常使用的方法中取消NaU考虑的新范式必须重新评估具有AKI风险的患者的管理。

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