Predictive and diagnostic tests of renal failure: a review.


Journal Article (Review)

Postoperative acute renal insufficiency is a discouraging complication with a mortality rate that remains persistently high, despite improved techniques of dialysis and advances in the perioperative management of hemodynamic, metabolic, and infective complications. A complete understanding of the role of renal hemodynamics in the pathophysiology of acute renal failure still has not emerged. Serial determination of creatinine clearance is currently the most sensitive test for predicting the onset of perioperative renal dysfunction; however, the test is not practical for measuring renal function under operating room conditions. Furthermore, testing creatinine clearance is time-consuming, labor intensive, and may cause significant delay in identifying the onset of renal dysfunction. That early therapy modifies the prognosis of renal dysfunction remains an untested hypothesis until a measurement that predicts renal outcome is found that is sensitive, specific, and easily obtainable. The ability to measure intrarenal blood flow distribution may offer promise for improving our predictive and diagnostic abilities to assess perioperative acute renal failure. Methodologic constraints, however, limit the practicality of this measurement in the perioperative setting at this time. Instead, we rely on indirect variables that do not bear a reliable relationship to glomerular filtration rate and renal function.

Full Text

Duke Authors

Cited Authors

  • Kellen, M; Aronson, S; Roizen, MF; Barnard, J; Thisted, RA

Published Date

  • January 1994

Published In

Volume / Issue

  • 78 / 1

Start / End Page

  • 134 - 142

PubMed ID

  • 8267149

Pubmed Central ID

  • 8267149

International Standard Serial Number (ISSN)

  • 0003-2999

Digital Object Identifier (DOI)

  • 10.1213/00000539-199401000-00022


  • eng

Conference Location

  • United States