Augmented Renal Clearance Following Traumatic Injury in Critically Ill Patients Requiring Nutrition Therapy
| Autor: | Joseph M. Swanson, Dina M. Filiberto, Roland N. Dickerson, Christin Crawford, Gayle Minard, Melissa Tsiu, Edward T. Van Matre, Cara Bujanowski |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Male medicine.medical_treatment Enteral administration chemistry.chemical_compound 0302 clinical medicine Risk Factors Brain Injuries Traumatic creatinine clearance Prevalence Medicine TX341-641 Medical nutrition therapy Renal Insufficiency Nutrition and Dietetics Nutritional Support creatinine Middle Aged Intensive Care Units trauma nutrition Anesthesia Injury Severity Score Female Nutrition Therapy Adult kidney augmented renal clearance Traumatic brain injury injury Critical Illness Renal function parenteral nutrition Article 03 medical and health sciences Renal Dialysis Humans enteral nutrition Obesity Dialysis Aged Retrospective Studies Creatinine 030109 nutrition & dietetics business.industry Nutrition. Foods and food supply 030208 emergency & critical care medicine medicine.disease Renal Elimination Parenteral nutrition chemistry Brain Injuries Multivariate Analysis business protein Food Science |
| Zdroj: | Nutrients Volume 13 Issue 5 Nutrients, Vol 13, Iss 1681, p 1681 (2021) |
| ISSN: | 2072-6643 |
| DOI: | 10.3390/nu13051681 |
| Popis: | The intent of this study was to ascertain the prevalence of augmented renal clearance (ARC) in patients with traumatic injuries who require nutrition therapy and identify factors associated with ARC. Adult patients admitted to the trauma intensive care unit from January 2015 to September 2016 who received enteral or parenteral nutrition therapy and had a 24 h urine collection within 4 to 14 days after injury were retrospectively evaluated. Patients with a serum creatinine concentration > 1.5 mg/dL, required dialysis, or had an incomplete urine collection were excluded. ARC was defined as a measured creatinine clearance > 149 mL/min/1.73 m2. Two hundred and three patients were evaluated. One hundred and two (50%) exhibited ARC. A greater proportion of patients with ARC were male (86% vs. 67% p = 0.004), had traumatic brain injury (33% vs. 9% p = 0.001), a higher injury severity score (30 ± 11 vs. 26 ± 12 p = 0.015), were younger (36 ± 15 vs. 54 ± 17 years p = 0.001), had a lower serum creatinine concentration (0.7 ± 2 vs. 0.9 ± 0.2 mg/dL p = 0.001) and were more catabolic (nitrogen balance of −10.8 ± 13.0 vs. −6.2 ± 9.2 g/d p = 0.004). The multivariate analysis revealed African American race and protein intake were also associated with ARC. Half of critically ill patients with traumatic injuries experience ARC. Patients with multiple risk factors for ARC should be closely evaluated for dosing of renally-eliminated electrolytes, nutrients, and medications. |
| Databáze: | OpenAIRE |
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