To the Editor Monitoring urine output remains essential to the care of adult patients admitted to the hospital. In acute, decompen- sated heart failure, ongoing assessment of urine output is required to adjust diureti...To the Editor Monitoring urine output remains essential to the care of adult patients admitted to the hospital. In acute, decompen- sated heart failure, ongoing assessment of urine output is required to adjust diuretic dosing in keeping with current recommendations for hospitalized patients, In patients with acute kidney injury, assessment of urine output is essential for diagnosis and management. The diagnosis of circulatory shock is supported by renal hypoperfusion as measured by low urine output. Indwelling urinary cathe- ters are routinely used for the ＂strict＂ monitoring of urine output, which is an accepted indication.展开更多
Background： Urine output （UO） is an essential criterion of the Kidney Disease Improving Global Outcomes （KD1GO） definition and classification system tbr acute kidney injury （AKI）, of which the diagnostic value ...Background： Urine output （UO） is an essential criterion of the Kidney Disease Improving Global Outcomes （KD1GO） definition and classification system tbr acute kidney injury （AKI）, of which the diagnostic value has not been extensively studied. We aimed to determine whether AKI based on KDIGO UO criteria （KDtGOLro） could improve the diagnostic and prognostic accuracy, compared with KDIGO serum creatinine criteria （KDIGOscr）.Methods： We conducted a secondary analysis of the database of a previous study conducted by China Critical Care Clinical Trial Group （CCCCTG）, which was a 2-month prospective cohort study （July 1,2009 to August 31,2009） involving 3063 patients in 22 tertiary Intensive Care Units in Mainland of China. AKI was diagnosed and classified separately based on KDIGOt,o and KDlGOsc,. Hospital mortality of patients with more severe AKI classification based on KDIGOvo was compared with other patients by univariate and multivariate regression analyses. Results： The prevalence of AKl increased from 52.4% based on KDIGOscr to 55.4% based on KD1GOsc~ combined with KDIGOuo. KDIGOv~~ also restllted in an upgrade of AKI classification in 7.3% of patients, representing those with more severe AK1 classification based on KDIGOvo. Compared with non-AKI patients or those with maximum AKI classification by KDIGOscr, those with maximum AKI classification by KDIGOuo had a significantly higher hospital mortality of 58.4% （odds ratio [OR]： 7.580, 95% confidence interval [CI]： 4.141-13.873, P 〈 0.001）. In a multivariate logistic regression analysis, AKI based on KDIGOuo （OR： 2.891, 95% CI： 1.964-4.254, P 〈 0.001）, but not based on KDIGOscr （OR： 1.322, 95% CI： 0.902-1.939, P = 0.152）, was an independent risk factor for hospital mortality. Conclusion： UO was a criterion with additional value beyond creatinine criterion for AKI diagnosis and classification, which can help identify a group of patients with high risk of death.展开更多
The objectives were to evaluate the effects of a liquid nutritional supplement formulated for dogs on water intakes and urine output. A liquid nutritional supplement was tested by way of a cross-over design in 8 exper...The objectives were to evaluate the effects of a liquid nutritional supplement formulated for dogs on water intakes and urine output. A liquid nutritional supplement was tested by way of a cross-over design in 8 experimental healthy Beagle dogs (4 males and 4 females, aged 9.3 years). The supplement (87 percent water, 2.7 percent protein, 2.6 percent fat, 0.4 percent crude fiber) was added to water and tested at 2 incorporation rates (50 or 70 ml/day/dog—D50 or D70) versus the control placebo (CO-water only). The dogs were kept in a controlled environment;water intakes and urine output were measured. Individual water intakes were characterised by large variations. Mean water intake increased significantly by 28 percent in dogs receiving the liquid nutritional supplement, in both genders, irrespectively of the dosage. Urine output was also increased, by 55 percent. Faeces scores remained unchanged. It was concluded that the liquid supplement increased water intake and urine output in a safe way, without increasing dramatically the daily dietary sodium chloride intake. The recommended dosage of the manufacturer—50 ml/day for dogs weighing 10 - 20 kg BW is efficient. Increasing the dosage had no advantage, nor adverse effects. Increased water intake and urine output is of interest for dogs suffering from urolithiasis.展开更多
OBJECTIVE:To test the effects of Zhuling decoction(猪苓汤)on patients with diuretic resistance in heart failure compared with a group of patients undergoing conventional treatment alone.METHODS:This research was a pro...OBJECTIVE:To test the effects of Zhuling decoction(猪苓汤)on patients with diuretic resistance in heart failure compared with a group of patients undergoing conventional treatment alone.METHODS:This research was a prospective,randomized,controlled study.From July 2018 to August 2020,96 diuretic resistance patients from the Cardiovascular Research Center of Taicang Hospital affiliated with Nanjing University of Traditional Chinese Medicine(GradeⅢHospital of Traditional Chinese Medicine)were enrolled in the study.The subjects were randomly divided into an observation group(48 cases)and a control group(48 cases).Patients in both groups received conventional treatment.In addition,observation group patients received Traditional Chinese Medicine Zhuling decoction.The primary endpoint was the urine output mean difference between Day 1 and Day 7 after treatment.Secondary endpoints were the changes over time in the N-terminal pro-B type natriuretic peptide(NTproBNP),New York Heart Association(NYHA)functional classification,and Minnesota Living with Heart Failure Questionnaire(MLHFQ).The safety and tolerability of the drug were comprehensively evaluated based on adverse drug reactions,as well as laboratory-assisted tests for liver and kidney function and electrolytes.RESULTS:Significant improvements were demonstrated for urine output in the two groups at Day 7,with a 1325 vs 1045 mL difference in favor of the observation group(P=0.018).The observation group also had greater improvements in NT-proBNP and NYHA functional classification changes than the control group.At the 30 th day of follow-up,a significant reduction in negative findings on the MLHFQ from baseline was observed in both groups,but the observation group demonstrated a significantly greater reduction than the control group(P<0.001).CONCLUSIONS:Zhuling decoction could be used in combination therapy for patients with diuretic resistance in heart failure in addition to standard treatment.展开更多
Chinese Medical Journal （ CMJ） is published semimonthly in English by the Chinese Medical Association, and is a peer reviewed general medical journal for all physicians, doctors, medical researchers, and health work...Chinese Medical Journal （ CMJ） is published semimonthly in English by the Chinese Medical Association, and is a peer reviewed general medical journal for all physicians, doctors, medical researchers, and health workers. The journal reports the advances and progress in current medical sciences and technology. It also serves the objective of international academic exchange.展开更多
文摘To the Editor Monitoring urine output remains essential to the care of adult patients admitted to the hospital. In acute, decompen- sated heart failure, ongoing assessment of urine output is required to adjust diuretic dosing in keeping with current recommendations for hospitalized patients, In patients with acute kidney injury, assessment of urine output is essential for diagnosis and management. The diagnosis of circulatory shock is supported by renal hypoperfusion as measured by low urine output. Indwelling urinary cathe- ters are routinely used for the ＂strict＂ monitoring of urine output, which is an accepted indication.
文摘Background： Urine output （UO） is an essential criterion of the Kidney Disease Improving Global Outcomes （KD1GO） definition and classification system tbr acute kidney injury （AKI）, of which the diagnostic value has not been extensively studied. We aimed to determine whether AKI based on KDIGO UO criteria （KDtGOLro） could improve the diagnostic and prognostic accuracy, compared with KDIGO serum creatinine criteria （KDIGOscr）.Methods： We conducted a secondary analysis of the database of a previous study conducted by China Critical Care Clinical Trial Group （CCCCTG）, which was a 2-month prospective cohort study （July 1,2009 to August 31,2009） involving 3063 patients in 22 tertiary Intensive Care Units in Mainland of China. AKI was diagnosed and classified separately based on KDIGOt,o and KDlGOsc,. Hospital mortality of patients with more severe AKI classification based on KDIGOvo was compared with other patients by univariate and multivariate regression analyses. Results： The prevalence of AKl increased from 52.4% based on KDIGOscr to 55.4% based on KD1GOsc~ combined with KDIGOuo. KDIGOv~~ also restllted in an upgrade of AKI classification in 7.3% of patients, representing those with more severe AK1 classification based on KDIGOvo. Compared with non-AKI patients or those with maximum AKI classification by KDIGOscr, those with maximum AKI classification by KDIGOuo had a significantly higher hospital mortality of 58.4% （odds ratio [OR]： 7.580, 95% confidence interval [CI]： 4.141-13.873, P 〈 0.001）. In a multivariate logistic regression analysis, AKI based on KDIGOuo （OR： 2.891, 95% CI： 1.964-4.254, P 〈 0.001）, but not based on KDIGOscr （OR： 1.322, 95% CI： 0.902-1.939, P = 0.152）, was an independent risk factor for hospital mortality. Conclusion： UO was a criterion with additional value beyond creatinine criterion for AKI diagnosis and classification, which can help identify a group of patients with high risk of death.
文摘The objectives were to evaluate the effects of a liquid nutritional supplement formulated for dogs on water intakes and urine output. A liquid nutritional supplement was tested by way of a cross-over design in 8 experimental healthy Beagle dogs (4 males and 4 females, aged 9.3 years). The supplement (87 percent water, 2.7 percent protein, 2.6 percent fat, 0.4 percent crude fiber) was added to water and tested at 2 incorporation rates (50 or 70 ml/day/dog—D50 or D70) versus the control placebo (CO-water only). The dogs were kept in a controlled environment;water intakes and urine output were measured. Individual water intakes were characterised by large variations. Mean water intake increased significantly by 28 percent in dogs receiving the liquid nutritional supplement, in both genders, irrespectively of the dosage. Urine output was also increased, by 55 percent. Faeces scores remained unchanged. It was concluded that the liquid supplement increased water intake and urine output in a safe way, without increasing dramatically the daily dietary sodium chloride intake. The recommended dosage of the manufacturer—50 ml/day for dogs weighing 10 - 20 kg BW is efficient. Increasing the dosage had no advantage, nor adverse effects. Increased water intake and urine output is of interest for dogs suffering from urolithiasis.
基金Supported by the 2019 Suzhou(Taicang)Science and Technology Development Plan(the fourth batch of basic research on people’s livelihood,science and technology,and medical and health applications).Project name:Applied research on diuretic resistance of Zhuling decoction.Project number:SYSD2019201,TC2019JCYL13
文摘OBJECTIVE:To test the effects of Zhuling decoction(猪苓汤)on patients with diuretic resistance in heart failure compared with a group of patients undergoing conventional treatment alone.METHODS:This research was a prospective,randomized,controlled study.From July 2018 to August 2020,96 diuretic resistance patients from the Cardiovascular Research Center of Taicang Hospital affiliated with Nanjing University of Traditional Chinese Medicine(GradeⅢHospital of Traditional Chinese Medicine)were enrolled in the study.The subjects were randomly divided into an observation group(48 cases)and a control group(48 cases).Patients in both groups received conventional treatment.In addition,observation group patients received Traditional Chinese Medicine Zhuling decoction.The primary endpoint was the urine output mean difference between Day 1 and Day 7 after treatment.Secondary endpoints were the changes over time in the N-terminal pro-B type natriuretic peptide(NTproBNP),New York Heart Association(NYHA)functional classification,and Minnesota Living with Heart Failure Questionnaire(MLHFQ).The safety and tolerability of the drug were comprehensively evaluated based on adverse drug reactions,as well as laboratory-assisted tests for liver and kidney function and electrolytes.RESULTS:Significant improvements were demonstrated for urine output in the two groups at Day 7,with a 1325 vs 1045 mL difference in favor of the observation group(P=0.018).The observation group also had greater improvements in NT-proBNP and NYHA functional classification changes than the control group.At the 30 th day of follow-up,a significant reduction in negative findings on the MLHFQ from baseline was observed in both groups,but the observation group demonstrated a significantly greater reduction than the control group(P<0.001).CONCLUSIONS:Zhuling decoction could be used in combination therapy for patients with diuretic resistance in heart failure in addition to standard treatment.
文摘Chinese Medical Journal （ CMJ） is published semimonthly in English by the Chinese Medical Association, and is a peer reviewed general medical journal for all physicians, doctors, medical researchers, and health workers. The journal reports the advances and progress in current medical sciences and technology. It also serves the objective of international academic exchange.
