The impact of acute kidney injury on the urea-to-creatinine ratio – A single-center retrospective analysis
Authors' conclusion
Evolving AKI was associated with a lower UCR during the early ICU course, limiting its reliability as a standalone marker of catabolism.
Study context
- Population
- Consecutive ICU patients at two ICUs, university hospital of Innsbruck
- Participants
- 1,567 patients · 2 ICUs
- Exposure
- Acute kidney injury (AKI) stages 0 vs I–III
- Outcome
- Temporal trajectories of UCR, urea generation rate and creatinine clearance by AKI stage
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
UCR, urea and creatinine trajectories
- Peak urea around days 6-7 across all groups
- Creatinine peak: day 2 in stage 0; days 4-5 in stages I-III
- AKI associated with significantly lower urea-to-creatinine ratio (UCR) early in ICU course, reversed later in ICU stay (time-dependent, non-monotonic)
- Urea generation rate fairly comparable between groups
Observational data: associations, not effects.
Further findings
Independent predictors of elevated UCR (>75 mg/dl per mg/dl) on day 4 (multivariate logistic regression)
- Higher urea generation rate, protein intake, SAPS III, corticosteroids and older age predicted elevated UCR
- AKI and male sex significantly reduced risk of elevated UCR
Original publication
The impact of acute kidney injury on the urea-to-creatinine ratio – A single-center retrospective analysis. J Crit Care. Published 25 September 2026. doi:10.
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