scholarly journals 871: IMPAIRED RENAL FUNCTION IS ASSOCIATED WITH HIGH CEFEPIME CONCENTRATIONS IN CRITICALLY ILL CHILDREN

2021 ◽  
Vol 50 (1) ◽  
pp. 431-431
Author(s):  
Kathryn Pavia ◽  
Sonya Tang Girdwood ◽  
Peter Tang ◽  
Calise Curry ◽  
Rhonda Jones ◽  
...  
Keyword(s):  
Renal Function ◽  
Critically Ill ◽  
Impaired Renal Function ◽  
Critically Ill Children

scholarly journals Acute kidney injury in paediatric intensive care: need for extended vigil

2019 ◽  
Vol 6 (2) ◽  
pp. 853
Author(s):  
Saritha P. J. ◽  
Jayakrishnan M. P. ◽  
Ashraf T. P. ◽  
Geeta M. G.
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Intensive Care ◽  
Serum Creatinine ◽  
Critically Ill ◽  
Impaired Renal Function ◽  
Kidney Injury ◽  
Referral Hospital ◽  
Critically Ill Children ◽  
Time Of Admission

Background: Acute kidney injury (AKI) is an important contributor towards morbidity and mortality among critically ill children. The objective of this study was to ascertain the etiological factors, categorize the severity and determine the immediate outcome of AKI among children admitted to the pediatric intensive care unit (PICU) of a tertiary referral hospital in south India.Methods: A prospective study was conducted from January to December 2012 in the PICU, Government medical college, kozhikode, a major referral hospital in north Kerala. The institutional ethics committee approved the study. Children in the age group of 1 month to 12 years admitted to the PICU for at least 48 hours were included if they had no previous renal disease/AKI at the time of admission. Serum creatinine levels of the children were measured at the time of admission, at 48 hours, and one month later. Outcome measures included normalization of serum creatinine or persistence of impaired renal function. Mortality was assessed both immediately and after one month.Results: A total of 1716 children were included in the study, of which 107 children developed AKI (6.2%). Among the 107 children, 56 children (52.3%) were boys. Majority of children were infants 75(70.1%). Infection was the commonest underlying condition   associated with AKI. Most of the children with acute kidney injury were in the earliest phase (Stage 1). Twenty-six children (24.29%) died. Among the survivors, 10% were found to have impaired renal function when followed up a month later.Conclusions: There is a high incidence of AKI in critically ill infants admitted in PICU. Residual renal impairment can persist even after discharge from hospital and these children need follow up for a longer time.

scholarly journals Substantial Impact of Altered Pharmacokinetics in Critically Ill Patients on the Antibacterial Effects of Meropenem Evaluated via the Dynamic Hollow-Fiber Infection Model

2017 ◽  
Vol 61 (5) ◽  
Author(s):  
Phillip J. Bergen ◽  
Jürgen B. Bulitta ◽  
Carl M. J. Kirkpatrick ◽  
Kate E. Rogers ◽  
Megan J. McGregor ◽  
...  
Keyword(s):  
Renal Function ◽  
Critically Ill ◽  
Hollow Fiber ◽  
Critically Ill Patients ◽  
Impaired Renal Function ◽  
Infection Model ◽  
Bacterial Killing ◽  
Renal Functions ◽  
Dosing Regimens ◽  
Susceptible Populations

ABSTRACT Critically ill patients frequently have substantially altered pharmacokinetics compared to non-critically ill patients. We investigated the impact of pharmacokinetic alterations on bacterial killing and resistance for commonly used meropenem dosing regimens. A Pseudomonas aeruginosa isolate (MICmeropenem 0.25 mg/liter) was studied in the hollow-fiber infection model (inoculum ∼107.5 CFU/ml; 10 days). Pharmacokinetic profiles representing critically ill patients with augmented renal clearance (ARC), normal, or impaired renal function (creatinine clearances of 285, 120, or ∼10 ml/min, respectively) were generated for three meropenem regimens (2, 1, and 0.5 g administered as 8-hourly 30-min infusions), plus 1 g given 12 hourly with impaired renal function. The time course of total and less-susceptible populations and MICs were determined. Mechanism-based modeling (MBM) was performed using S-ADAPT. All dosing regimens across all renal functions produced similar initial bacterial killing (≤∼2.5 log10). For all regimens subjected to ARC, regrowth occurred after 7 h. For normal and impaired renal function, bacterial killing continued until 23 to 47 h; regrowth then occurred with 0.5- and 1-g regimens with normal renal function (fT >5×MIC = 56 and 69%, fC min/MIC < 2); the emergence of less-susceptible populations (≥32-fold increases in MIC) accompanied all regrowth. Bacterial counts remained suppressed across 10 days with normal (2-g 8-hourly regimen) and impaired (all regimens) renal function (fT >5×MIC ≥ 82%, fC min/MIC ≥ 2). The MBM successfully described bacterial killing and regrowth for all renal functions and regimens simultaneously. Optimized dosing regimens, including extended infusions and/or combinations, supported by MBM and Monte Carlo simulations, should be evaluated in the context of ARC to maximize bacterial killing and suppress resistance emergence.

scholarly journals Impact of administration of vancomycin or linezolid to critically ill patients with impaired renal function

2011 ◽  
Vol 30 (5) ◽  
pp. 635-643 ◽  
Author(s):  
O. Rodriguez Colomo ◽  
◽  
F. Álvarez Lerma ◽  
M.I. González Pérez ◽  
J-M. Sirvent ◽  
...  
Keyword(s):  
Renal Function ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Impaired Renal Function

Renal Function Follow-Up and Renal Recovery After Acute Kidney Injury in Critically Ill Children*

2017 ◽  
Vol 18 (8) ◽  
pp. 733-740 ◽  
Author(s):  
Erin Hessey ◽  
Rami Ali ◽  
Marc Dorais ◽  
Geneviève Morissette ◽  
Michael Pizzi ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Critically Ill ◽  
Kidney Injury ◽  
Renal Recovery ◽  
Critically Ill Children

scholarly journals P25 Comparison of renal function estimation methods in critically ill children: a pilot study

2019 ◽  
Vol 104 (6) ◽  
pp. e27.1-e27
Author(s):  
E Dhont ◽  
T Van Der Heggen ◽  
A De Jaeger ◽  
J Willems ◽  
S De Baere ◽  
...  
Keyword(s):  
Renal Function ◽  
Intensive Care ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Critically Ill ◽  
Filtration Rate ◽  
University Hospital ◽  
Estimation Methods ◽  
Critically Ill Children ◽  
List Type

BackgroundAccurate assessment of renal function is crucial in intensive care to guide therapy. Both acute kidney injury and augmented renal clearance (ARC) may compromise outcome. Common formulas to estimate glomerular filtration rate (GFR) are unreliable in critically ill adults.1 A comparison of a gold standard technique to assess GFR with these formula-based estimations has never been reported in pediatric intensive care (PICU) patients. Our aim was to evaluate the feasibility of measuring plasma iohexol clearance (CLIOHEX) for GFR assessment in critically ill children and to compare CLIOHEX with estimated GFR using the modified Schwartz formula (eGFRSchwartz).MethodsA prospective, interventional study was conducted at the PICU of the Ghent University Hospital, Belgium. Critically ill children without chronic kidney disease were included. After injection of a weight-dependent bolus of iohexol, serial blood samples (n=6) were taken over a 6-hours interval. CLIOHEX was compared to eGFRSchwartz. Correlation between both methods was assessed by a Pearson´s correlation coefficient (r).Bland-Altman plots were evaluated to assess bias and limits of agreement (LOA). ARC was defined as a GFR exceeding normal values for age plus two standard deviations.Results40 patients, median age 16 months (range 15 days -13,6 years), 72,5% males, were included. No adverse effects related to iohexol were observed. Median CLIOHEX was 121 ml/min/1.73m2 (range: 43–221 ml/min/1.73m2). ARC was present in 20 patients based on CLIOHEX. Median eGFRSchwartz was 81 ml/min/1.73m2 (range: 31–131 ml/min/1.73m2). Only 1 patient was identified with ARC by eGFRSchwartz. eGFRSchwartz was systematically lower than CLIOHEX. There was a good correlation between CLIOHEX and eGFRSchwartz (r = 0,69; p< 0,01). Bias was 34 ml/min/1.73m2 with LOA (-24,5; 93 ml/min/1.73m2)ConclusionCLIOHEX was safely used to measure true GFR in critically ill children. eGFRSchwartz systematically underestimates GFR, especially in patients with ARC and seems not reliable in this patient population.ReferenceBaptista JP, Neves M, Rodrigues L, Teixeira L, Pinho J, Pimentel J ( 2014) Accuracy of the estimation of glomerular filtration rate within a population of critically ill patients. J Nephrol. 27:403–410.Disclosure(s)Nothing to disclose

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