Estimating creatinine clearance for Malaysian critically ill patients with unstable kidney function and impact on dosage adjustment
| Autor: | Angel Wei Ling Goh, Yen Ping Ng, Chee Ping Chong |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Creatinine Kidney Critically ill business.industry Urology Renal function Retrospective cohort study urologic and male genital diseases Intensive care unit law.invention chemistry.chemical_compound medicine.anatomical_structure chemistry law medicine Dosage adjustment Dosing General Pharmacology Toxicology and Pharmaceutics business |
| Zdroj: | International Journal of Research in Pharmaceutical Sciences. 11:2825-2837 |
| ISSN: | 0975-7538 |
| DOI: | 10.26452/ijrps.v11i3.2358 |
| Popis: | It is an essential requirement to estimate glomerular filtration rate in dosing adjustment of drug treatment for critically ill patients with unstable kidney function. Previous studies showed that Cockcroft-Gault equation was not appropriate for the assessment of unstable kidney function. However, there is a lack of assessment on other equations specifically designed for fluctuating kidney functions. This study is aimed to evaluate the differences between estimated creatinine clearances by using Cockcroft-Gault, Jelliffe, Brater, and Chiou equations and the impact on dosing adjustment of renally excreted drugs for critically ill patients with unstable kidney function. A retrospective observational study was conducted among 103 patients with unstable kidney function who were admitted to intensive care unit of Taiping Hospital, Malaysia. Serum creatinine levels from day 1 to 7 of admission were collected. The median differences of estimated creatinine clearance based on the four different equations were analysed by Friedman-ANOVA test. The median estimated creatinine clearances when patients were having fluctuating kidney functions showed 35.69 ml/min (IQR: 22.57 – 53.97) by Cockcroft-Gault and 22.64 ml/min (IQR: 10.46 – 38.49) by Jelliffe equation, while Brater and Chiou equations showed 35.88 ml/min (IQR: 19.46 – 56.04) and 30.10 ml/min (IQR: 16.55 – 46.82) respectively. Jelliffe and Chiou equation showed a significant 36.56% and 15.66% lower estimated creatinine clearance respectively as compared to Cockcroft-Gault (p < 0.001). Meanwhile, there was no significant difference between Brater and Cockcroft-Gault equation. Jelliffe equation demonstrated the lowest estimated creatinine clearance value with a more intense dosage adjustment required for patients’ drug regimen involving renally excreted drugs. In conclusion, there were clinically significant variations in the estimated creatinine clearance from the different equations. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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