Augmented renal clearance is a common finding with worse clinical outcome in critically ill patients receiving antimicrobial therapy
| Autor: | Johan Decruyenaere, Jan J. De Waele, Kirsten Colpaert, Hugo Robays, Barbara Claus, Eric Hoste |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty Critical Illness Renal function Kidney Function Tests Critical Care and Intensive Care Medicine law.invention Arc (geometry) chemistry.chemical_compound Anti-Infective Agents Belgium Risk Factors Interquartile range law Internal medicine Outcome Assessment Health Care medicine Humans Prospective Studies APACHE Aged Body surface area Creatinine APACHE II business.industry Incidence Incidence (epidemiology) Acute Kidney Injury Middle Aged Intensive care unit Surgery chemistry Female business |
| Zdroj: | Journal of Critical Care. 28:695-700 |
| ISSN: | 0883-9441 |
| DOI: | 10.1016/j.jcrc.2013.03.003 |
| Popis: | We describe incidence and patient factors associated with augmented renal clearance (ARC) in adult intensive care unit (ICU) patients.A prospective observational study in a mixed cohort of surgical and medical ICU patients receiving antimicrobial therapy at the Ghent University Hospital, Belgium. Kidney function was assessed by the 24-hour creatinine clearance (Ccr); ARC defined as at least one Ccr of130 mL/min per 1.73 m2. Multivariate logistic regression analysis: to assess variables associated with ARC occurrence. Therapeutic failure (TF): an impaired clinical response and need for alternate antimicrobial therapy.Of the 128 patients and 599 studied treatment days, ARC was present in 51.6% of the patients. Twelve percent permanently expressed ARC. ARC patients had a median Ccr of 144 mL/min per 1.73 m2 (IQR 98-196). Median serum creatinine concentration on the first day of ARC was 0.54 mg/dL (IQR 0.48-0.69). Patients with ARC were significantly younger (P.001). Age and male gender were independently associated with ARC whereas the APACHE II score was not. ARC patients had more TF (18 (27.3%) vs. 8 (12.9%); P=.04).ARC was documented in approximately 52% of a mixed ICU patient population receiving antibiotic treatment with worse clinical outcome. Young age and male gender were independently associated with ARC presence. |
| Databáze: | OpenAIRE |
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