Association of Oliguria With Acute Kidney Injury, Chronic Kidney Disease, and Mortality: Determining the Optimal Threshold in Critically Ill Patients
Authors' conclusion
The risk of mortality or persistent kidney injury, reflected by incident CKD, increases at a lower urine output threshold than the current AKI definition. These findings support the idea of filtration deficit, urine output, and tissue injury as different dimensions of AKI and should influence future AKI definitions.
Study context
- Population
- Adults (≥ 18 yr) without preexisting chronic kidney disease (CKD) admitted to the Uppsala University Hospital ICU, Sweden, between 2017 and 2024adults admitted to the ICU
- Participants
- 4,999 adults
- Exposure
- Thresholds of lowest mean diuresis (LMD) over 3, 6, 12, and 24 hours associated with acute kidney injury (AKI), CKD, and mortality
- Outcome
- Association of LMD (all time frames) with AKI, CKD, and death
Main finding
As reported in the abstract
- All LMD time frames significantly associated with AKI, CKD, and death
- p < 0.0001
Observational data: associations, not effects.
Further findings
LMD thresholds for AKI within 7 days of LMD (Kidney Disease Improving Global Outcomes creatinine criteria)
mL/kg/hr
- LMD3h
- 0.43
- LMD6h
- 0.41
- LMD12h
- 0.42
- LMD24h
- 0.53
LMD thresholds for incident CKD after ICU discharge
mL/kg/hr
- LMD3h
- 0.21
- LMD6h
- 0.21
- LMD12h
- 0.31
- LMD24h
- 0.43
LMD thresholds for 90-day mortality
- LMD3h
- 0.16
- LMD6h
- 0.18
- LMD12h
- 0.24
- LMD24h
- 0.39
Original publication
Association of Oliguria With Acute Kidney Injury, Chronic Kidney Disease, and Mortality: Determining the Optimal Threshold in Critically Ill Patients. Crit Care Med. Published 14 October 2026. doi:10.
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