Augmented Renal Clearance in the Critically Ill: How to Assess Kidney Function

2012 ◽  
Vol 46 (7-8) ◽  
pp. 952-959 ◽  
Author(s):  
Veerle Grootaert ◽  
Ludo Willems ◽  
Yves Debaveye ◽  
Geert Meyfroidt ◽  
Isabel Spriet
Keyword(s):  
Renal Clearance ◽  
Critically Ill ◽  
Kidney Function ◽  
Augmented Renal Clearance

Augmented Renal Clearance in Critically Ill Patients: A Systematic Review

2018 ◽  
Vol 57 (9) ◽  
pp. 1107-1121 ◽  
Author(s):  
Idoia Bilbao-Meseguer ◽  
Alicia Rodríguez-Gascón ◽  
Helena Barrasa ◽  
Arantxazu Isla ◽  
María Ángeles Solinís
Keyword(s):  
Systematic Review ◽  
Renal Clearance ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Augmented Renal Clearance

Augmented Renal Clearance in Critically Ill Pediatric Patients

2017 ◽  
Vol 18 (9) ◽  
pp. 901-902 ◽  
Author(s):  
John N. van den Anker ◽  
Catherijne A. J. Knibbe ◽  
Dick Tibboel
Keyword(s):  
Renal Clearance ◽  
Critically Ill ◽  
Pediatric Patients ◽  
Augmented Renal Clearance

scholarly journals Augmented Renal Clearance in Iranian Critically Ill Patients: Retrospective Study at Masih Daneshvari Hospital

2017 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Seyed Reza Saghebi ◽  
Behrooz Farzanegan ◽  
Payam Tabarsi ◽  
Rokhsaneh Zangooi ◽  
Batoul Khoundabi ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Renal Clearance ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Augmented Renal Clearance

scholarly journals Augmented Renal Clearance, Muscle Catabolism and Urinary Nitrogen Loss: Implications for Nutritional Support in Critically Ill Trauma Patients

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3554
Author(s):  
Guilhem Dreydemy ◽  
Alexis Coussy ◽  
Alexandre Lannou ◽  
Laurent Petit ◽  
Matthieu Biais ◽  
...  
Keyword(s):  
Renal Clearance ◽  
Critically Ill ◽  
Nitrogen Balance ◽  
Protein Intake ◽  
Nitrogen Loss ◽  
Secondary Outcome ◽  
Trauma Patients ◽  
Augmented Renal Clearance ◽  
Abdominal Ct ◽  
Urinary Nitrogen

The main objective of this pilot study was to determine the association between augmented renal clearance (ARC), urinary nitrogen loss and muscle wasting in critically ill trauma patients. We conducted a retrospective analysis of a local database in 162 critically ill trauma patients without chronic renal dysfunction. Nutritional-related parameters and 24 h urinary biochemical analyses were prospectively collected and averaged over the first ten days after admission. Augmented renal clearance was defined by a mean creatinine clearance (CLCR) > 130 mL/min/1.73 m2. The main outcome was the cumulated nitrogen balance at day 10. The secondary outcome was the variation of muscle psoas cross-sectional area (ΔCSA) calculated in the subgroup of patients who underwent at least two abdominal CT scans during the ICU length of stay. Overall, there was a significant correlation between mean CLCR and mean urinary nitrogen loss (normalized coefficient: 0.47 ± 0.07, p < 0.0001). ARC was associated with a significantly higher urinary nitrogen loss (17 ± 5 vs. 14 ± 4 g/day, p < 0.0001) and a lower nitrogen balance (−6 ± 5 vs. −4 ± 5 g/day, p = 0.0002), without difference regarding the mean protein intake (0.7 ± 0.2 vs. 0.7 ± 0.3 g/kg/day, p = 0.260). In the subgroup of patients who underwent a second abdominal CT scan (N = 47), both ΔCSA and %ΔCSA were higher in ARC patients (−33 [−41; −25] vs. −15 [−29; −5] mm2/day, p = 0.010 and −3 [−3; −2] vs. −1 [−3; −1] %/day, p = 0.008). Critically ill trauma patients with ARC are thus characterized by a lower nitrogen balance and increased muscle loss over the 10 first days after ICU admission. The interest of an increased protein intake (>1.5 g/kg/day) in such patients remains a matter of controversy and must be confirmed by further randomized trials.

661: PK/PD AND SAFETY OF 3 G CEFTOLOZANE/TAZOBACTAM IN CRITICALLY ILL AUGMENTED RENAL CLEARANCE PATIENTS

2016 ◽  
Vol 44 (12) ◽  
pp. 241-241 ◽  
Author(s):  
Luzelena Caro ◽  
Kajal Larson ◽  
David Nicolau ◽  
Jan DeWaele ◽  
Joseph Kuti ◽  
...  
Keyword(s):  
Renal Clearance ◽  
Critically Ill ◽  
Augmented Renal Clearance

scholarly journals Select Critically ill Patients at Risk of Augmented Renal Clearance: Experience in a Malaysian Intensive Care Unit

2014 ◽  
Vol 42 (6) ◽  
pp. 715-722 ◽  
Author(s):  
S. Adnan ◽  
S. Ratnam ◽  
S. Kumar ◽  
D. Paterson ◽  
J. Lipman ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
At Risk ◽  
Intensive Care ◽  
Serum Creatinine ◽  
Creatinine Clearance ◽  
Renal Clearance ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Augmented Renal Clearance ◽  
Drug Concentrations

Augmented renal clearance (ARC) refers to increased solute elimination by the kidneys. ARC has considerable implications for altered drug concentrations. The aims of this study were to describe the prevalence of ARC in a select cohort of patients admitted to a Malaysian intensive care unit (ICU) and to compare measured and calculated creatinine clearances in this group. Patients with an expected ICU stay of >24 hours plus an admission serum creatinine concentration <120 μmol/l, were enrolled from May to July 2013. Twenty-four hour urinary collections and serum creatinine concentrations were used to measure creatinine clearance. A total of 49 patients were included, with a median age of 34 years. Most study participants were male and admitted after trauma. Thirty-nine percent were found to have ARC. These patients were more commonly admitted in emergency ( P=0.03), although no other covariants were identified as predicting ARC, likely due to the inclusion criteria and the study being under-powered. Significant imprecision was demonstrated when comparing calculated Cockcroft-Gault creatinine clearance (Crcl) and measured Crcl. Bias was larger in ARC patients, with Cockcroft-Gault Crcl being significantly lower than measured Crcl ( P <0.01) and demonstrating poor correlation (rs=-0.04). In conclusion, critically ill patients with ‘normal’ serum creatinine concentrations have varied Crcl. Many are at risk of ARC, which may necessitate individualised drug dosing. Furthermore, significant bias and imprecision between calculated and measured Crcl exists, suggesting clinicians should carefully consider which method they employ in assessing renal function.

Sign in / Sign up

Export Citation Format

Share Document