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VOLUME 8 , ISSUE 1 ( January-June, 2023 ) > List of Articles


Feasibility and Clinical Experience of Arterial-urinary Oxygen (PaO2–PuO2) Gradient Monitoring for Early Detection of Acute Renal Failure in COVID-19 Patient: A Clinical Case Series

Amarjeet Kumar, Ajeet Kumar, Kunal Singh, Adarsh M Sheshagiri

Keywords : Acute kidney injury, Coronavirus disease 2019, Hypoxemia

Citation Information : Kumar A, Kumar A, Singh K, Sheshagiri AM. Feasibility and Clinical Experience of Arterial-urinary Oxygen (PaO2–PuO2) Gradient Monitoring for Early Detection of Acute Renal Failure in COVID-19 Patient: A Clinical Case Series. Res Inno Anesth 2023; 8 (1):26-28.

DOI: 10.5005/jp-journals-10049-2023

License: CC BY-NC 4.0

Published Online: 22-05-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Mechanisms of coronavirus disease 2019 (COVID-19) induced acute kidney injury (AKI) include local tissue inflammation due to immunological responses and activation of coagulation pathways following endothelial damage. It has been shown that reduced oxygen supply and renal hypoxia are significant risk factors for the development of AKI in postcardiac surgery patients. The urinary oxygen partial pressure (PuO2) of the first discharged urine is comparable to that of the renal medulla. Therefore, the real-time monitoring of PuO2 can be used to predict renal hypoxia and the risk of AKI in COVID-19 patients who are hospitalized [intensive care unit (ICU)]. In this observational study, we did a single time point measurement of blood–urine gas analysis in addition to routine arterial blood gas analysis in 20 critically ill COVID-19 patients. In this case series, we couldn't find an association between stagnant urine PuO2 and renal hypoxia. However, serial monitoring of PuO2 by urinary oximeter can be used for early detection of medullary hypoxia.

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