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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Crit Care Med. Dec 9, 2025; 14(4): 109194
Published online Dec 9, 2025. doi: 10.5492/wjccm.v14.i4.109194
Published online Dec 9, 2025. doi: 10.5492/wjccm.v14.i4.109194
Giving urine biochemistry a second chance in acute kidney injury monitoring
Alexandre Toledo Maciel, Department of Research, Imed Group, Hospital São Camilo Pompéia Adult ICU, São Paulo 05022-001, Brazil
Author contributions: Maciel AT conceived the review, collected the clinical and laboratory data, and wrote the paper, producing this manuscript on behalf of the Imed Group of Investigators.
Conflict-of-interest statement: The author declares no conflicts of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Alexandre Toledo Maciel, Head, MD, Department of Research, Imed Group, Hospital São Camilo Pompéia Adult ICU, Pompeia Avenue 1178 4th floor, São Paulo 05022-001, Brazil. alexandre.toledo@imedgroup.com.br
Received: May 6, 2025
Revised: June 4, 2025
Accepted: July 22, 2025
Published online: December 9, 2025
Processing time: 210 Days and 22.9 Hours
Revised: June 4, 2025
Accepted: July 22, 2025
Published online: December 9, 2025
Processing time: 210 Days and 22.9 Hours
Core Tip
Core Tip: The utility of urine biochemistry assessment for acute kidney injury (AKI) monitoring was proposed 50 years ago, being theoretically capable of defining AKI pathophysiology and distinguishing functional (“pre-renal”) and structural (“renal”) impairments. However, the actual usefulness of urine biochemistry was never confirmed due to variable and controversial results among studies. In this review, alternative considerations for when to assess urine electrolytes and how to interpret their values for renal function monitoring are proposed.