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Measured versus estimated creatinine clearance in critically ill patients with acute kidney injury: an observational study

Authors :
Sara Kadivarian
Fatemeh Heydarpour
Hasanali Karimpour
Foroud Shahbazi
Source :
Acute and Critical Care, Vol 37, Iss 2, Pp 185-192 (2022)
Publication Year :
2022
Publisher :
Korean Society of Critical Care Medicine, 2022.

Abstract

Background Acute kidney injury (AKI) commonly occurs in critically ill patients. Estimation of renal function and antibiotics dose adjustment in patients with AKI is a challenging issue. Methods Urinary creatinine clearance was measured in a 6-hour urine collection from patients with acute kidney injuries. The correlations between different formulas including the modified Cockcroft-Gault, modification of diet in renal disease, chronic kidney disease-epidemiology collaboration, Jelliffe, kinetic-glomerular filtration rate (GFR), Brater, and Chiou formulas were considered. The pattern of the prescribed antimicrobial agents was also compared with the patterns in the available resources. Results Ninety-five patients with acute kidney injuries were included in the research. The mean age of the participants was 63.11±17.58 years old. The most patients (77.89%) were in stage 1 of AKI according to the Acute Kidney Injury Network criteria, followed by stage 2 (14.73%) and stage 3 (7.36), respectively. None of the formulations had a high or very high correlation with the measured creatinine clearance. In stage 1, Chiou (r=0.26), and in stage 2 and 3, kinetic-GFR (r=0.76 and r=0.37) had the highest correlation coefficient. Antibiotic over- and under-dosing were frequently observed in the study. Conclusions The results showed that none of the static methods can predict the measured creatinine clearance in the critically ill patients. The dynamic methods such as kinetic-GFR can be helpful for patients who do not receive diuretics and vasopressors. Further studies are needed to confirm our results.

Details

Language :
English
ISSN :
25866052 and 25866060
Volume :
37
Issue :
2
Database :
Directory of Open Access Journals
Journal :
Acute and Critical Care
Publication Type :
Academic Journal
Accession number :
edsdoj.bb303e6d4148d98f46da314977461a
Document Type :
article
Full Text :
https://doi.org/10.4266/acc.2021.01256