Augmented renal clearance in critically ill patients with sepsis: prevalence, risk factors and outcome

Introduction: Augmented renal clearance (ARC) is a phenomenon where there is elevated renal clearance and defined by creatinine clearance > 130ml/min. ARC results in changes of the pharmacokinetic and pharmacodynamic of antimicrobial therapy being administered, which may result in its subtherapeu...

Full description

Bibliographic Details
Main Authors:	Abdul Rahim, Shahir Asraf, Md Ralib, Azrina, Mohamed, Abdul Hadi, Osman, Ariff, Mat Nor, Mohd Basri
Format:	Conference or Workshop Item
Language:	English
Published:	2017
Subjects:	R Medicine (General)
Online Access:	http://irep.iium.edu.my/58146/ http://irep.iium.edu.my/58146/ http://irep.iium.edu.my/58146/1/58146_Augmented%20Renal%20Clearance.pdf

id	iium-58146
recordtype	eprints
spelling	iium-581462017-08-25T08:44:21Z http://irep.iium.edu.my/58146/ Augmented renal clearance in critically ill patients with sepsis: prevalence, risk factors and outcome Abdul Rahim, Shahir Asraf Md Ralib, Azrina Mohamed, Abdul Hadi Osman, Ariff Mat Nor, Mohd Basri R Medicine (General) Introduction: Augmented renal clearance (ARC) is a phenomenon where there is elevated renal clearance and defined by creatinine clearance > 130ml/min. ARC results in changes of the pharmacokinetic and pharmacodynamic of antimicrobial therapy being administered, which may result in its subtherapeutic dose. We evaluated the prevalence, risk factors and outcome of ARC in critically ill patients with sepsis. Methods: This is an interim analysis of single centre, prospective observational study of critically ill patients. Inclusion criteria were patients older than 18 years old with sepsis with plasma creatinine <130 µmol/l. Urinary creatinine and flow rate were measured and creatinine clearance (CrCl) calculated. ARC is defined as CrCl of more 130 ml/min. Ultrasonic cardiac output montoring (USCOM) was used to measure cardiac index. Results: Nineteen patients were analysed so far, of which 11 (57.9%) had ARC. There were no differences age, gender, or category of patients between patients with and without ARC. Baseline APACHE II and SOFA score were similar in the two groups (p=0.47 and 0.06, respectively). There was no difference in the hospital mortality (p=0.86). However, duration of ICU admission amongst survivors was longer in patients with ARC (10 (5-12) vs 4 (3-5) days, p=0.04). Of the 11 with ARC, 7 persisted to day 2. Measured creatinine clearance correlated well with the estimated glomerular filtration rate (r=0.68, p<0.0001), however it did not correlate with cardiac index (r=0.40, p=0.14). Conclusions: ARC occurs in almost half of critically ill patients with sepsis, and is associated with longer duration of ICU stay. However, there was no difference in the outcome in this small study. Future larger study may be important to investigate this. 2017-08-10 Conference or Workshop Item NonPeerReviewed application/pdf en http://irep.iium.edu.my/58146/1/58146_Augmented%20Renal%20Clearance.pdf Abdul Rahim, Shahir Asraf and Md Ralib, Azrina and Mohamed, Abdul Hadi and Osman, Ariff and Mat Nor, Mohd Basri (2017) Augmented renal clearance in critically ill patients with sepsis: prevalence, risk factors and outcome. In: Medical Research Symposium 2017, 10th August 2017, Kuantan, Pahang. (Unpublished) http://www.iium.edu.my/medicine/news/medical-research-symposium-mrs-2017
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English
topic	R Medicine (General)
spellingShingle	R Medicine (General) Abdul Rahim, Shahir Asraf Md Ralib, Azrina Mohamed, Abdul Hadi Osman, Ariff Mat Nor, Mohd Basri Augmented renal clearance in critically ill patients with sepsis: prevalence, risk factors and outcome
description	Introduction: Augmented renal clearance (ARC) is a phenomenon where there is elevated renal clearance and defined by creatinine clearance > 130ml/min. ARC results in changes of the pharmacokinetic and pharmacodynamic of antimicrobial therapy being administered, which may result in its subtherapeutic dose. We evaluated the prevalence, risk factors and outcome of ARC in critically ill patients with sepsis. Methods: This is an interim analysis of single centre, prospective observational study of critically ill patients. Inclusion criteria were patients older than 18 years old with sepsis with plasma creatinine <130 µmol/l. Urinary creatinine and flow rate were measured and creatinine clearance (CrCl) calculated. ARC is defined as CrCl of more 130 ml/min. Ultrasonic cardiac output montoring (USCOM) was used to measure cardiac index. Results: Nineteen patients were analysed so far, of which 11 (57.9%) had ARC. There were no differences age, gender, or category of patients between patients with and without ARC. Baseline APACHE II and SOFA score were similar in the two groups (p=0.47 and 0.06, respectively). There was no difference in the hospital mortality (p=0.86). However, duration of ICU admission amongst survivors was longer in patients with ARC (10 (5-12) vs 4 (3-5) days, p=0.04). Of the 11 with ARC, 7 persisted to day 2. Measured creatinine clearance correlated well with the estimated glomerular filtration rate (r=0.68, p<0.0001), however it did not correlate with cardiac index (r=0.40, p=0.14). Conclusions: ARC occurs in almost half of critically ill patients with sepsis, and is associated with longer duration of ICU stay. However, there was no difference in the outcome in this small study. Future larger study may be important to investigate this.
format	Conference or Workshop Item
author	Abdul Rahim, Shahir Asraf Md Ralib, Azrina Mohamed, Abdul Hadi Osman, Ariff Mat Nor, Mohd Basri
author_facet	Abdul Rahim, Shahir Asraf Md Ralib, Azrina Mohamed, Abdul Hadi Osman, Ariff Mat Nor, Mohd Basri
author_sort	Abdul Rahim, Shahir Asraf
title	Augmented renal clearance in critically ill patients with sepsis: prevalence, risk factors and outcome
title_short	Augmented renal clearance in critically ill patients with sepsis: prevalence, risk factors and outcome
title_full	Augmented renal clearance in critically ill patients with sepsis: prevalence, risk factors and outcome
title_fullStr	Augmented renal clearance in critically ill patients with sepsis: prevalence, risk factors and outcome
title_full_unstemmed	Augmented renal clearance in critically ill patients with sepsis: prevalence, risk factors and outcome
title_sort	augmented renal clearance in critically ill patients with sepsis: prevalence, risk factors and outcome
publishDate	2017
url	http://irep.iium.edu.my/58146/ http://irep.iium.edu.my/58146/ http://irep.iium.edu.my/58146/1/58146_Augmented%20Renal%20Clearance.pdf
first_indexed	2023-09-18T21:22:11Z
last_indexed	2023-09-18T21:22:11Z
_version_	1777411955898712064

Augmented renal clearance in critically ill patients with sepsis: prevalence, risk factors and outcome

Similar Items