Urinary oxygen tension and its role in predicting acute kidney injury: A narrative review

J Clin Anesth. 2024 May:93:111359. doi: 10.1016/j.jclinane.2023.111359. Epub 2023 Dec 6.

Abstract

Acute kidney injury occurs frequently in the perioperative setting. The renal medulla often endures hypoxia or hypoperfusion and is susceptible to the imbalance between oxygen supply and demand due to the nature of renal blood flow distribution and metabolic rate in the kidney. The current available evidence demonstrated that the urine oxygen pressure is proportional to the variations of renal medullary tissue oxygen pressure. Thus, urine oxygenation can be a candidate for reflecting the change of oxygen in the renal medulla. In this review, we discuss the basic physiology of acute kidney injury, as well as techniques for monitoring urine oxygen tension, confounding factors affecting the reliable measurement of urine oxygen tension, and its clinical use, highlighting its potential role in early detection and prevention of acute kidney injury.

Keywords: Acute kidney injury; Perioperative; Renal medullary hypoxia; Tissue oxygenation; Urinary oxygen tension.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Kidney Injury* / diagnosis
  • Acute Kidney Injury* / etiology
  • Humans
  • Hypoxia / diagnosis
  • Hypoxia / etiology
  • Kidney Medulla / blood supply
  • Kidney Medulla / metabolism
  • Kidney*
  • Oxygen / metabolism
  • Oxygen Consumption
  • Renal Circulation / physiology

Substances

  • Oxygen