Development of glomerular filtration rate monitor based on creatinine kinetic modelling in critically ill patients

Background: Creatinine kinetic denotes that under steady state, creatinine production (G) equals to creatinine excretion rate (E), and if production exceeds excretion, GFR is impaired. Kinetic estimate of GFR (keGFR) offers a more accurate estimate of GFR in the acute settings with rapidly changing...

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Main Authors:	Md Ralib, Azrina, Mat Nor, Mohd Basri, Mohamed, Rozilah @ Abdul Hadi, Abdullah, Norzamzila, Jamaludin, Ummu Kulthum, Dzaharudin, Fatimah
Format:	Monograph
Language:	English
Published:	2018
Subjects:	R Medicine (General)
Online Access:	http://irep.iium.edu.my/67922/ http://irep.iium.edu.my/67922/1/Profile%20of%20Final%20Report_FRGS-15-235-0476.pdf

id	iium-67922
recordtype	eprints
spelling	iium-679222019-01-11T03:48:28Z http://irep.iium.edu.my/67922/ Development of glomerular filtration rate monitor based on creatinine kinetic modelling in critically ill patients Md Ralib, Azrina Mat Nor, Mohd Basri Mohamed, Rozilah @ Abdul Hadi Abdullah, Norzamzila Jamaludin, Ummu Kulthum Dzaharudin, Fatimah R Medicine (General) Background: Creatinine kinetic denotes that under steady state, creatinine production (G) equals to creatinine excretion rate (E), and if production exceeds excretion, GFR is impaired. Kinetic estimate of GFR (keGFR) offers a more accurate estimate of GFR in the acute settings with rapidly changing kidney functions. Objectives: We evaluated keGFR and E/eG ratio in diagnosis of AKI and its recovery. We also compared their diagnostic ability to the plasma Cystatin C and NGAL. Methods: This was a prospective observational study of critically ill patients. Inclusion criteria were patients >18 years old with sepsis and procalcitonin>0.5ng/ml. Results: 70 patients were recruited. keGFR had the least bias with the mean differences nearest to zero (-18 ml/min) when compared to CrCl. keGFRCr and keGFRCysC were strongly diagnostic of AKI with AUC of 0.93 (0.87 to 0.99). In 39 patients with AKI, 15 recovered within 3 days. In these cases, E/eG ratio strongly predicted AKI recovery (AUC 0.83 (0.69 to 0.97)). The AUC of plasma NGAL were highest for AKI diagnosed by keGFR on Day 1 and Day 2, and by E/eG ratio on Day 3. Conclusions: In critically ill patients with sepsis, keGFRCr and keGFRCysC had the least bias and fair precision when compared to CrCl. They diagnosed AKI with cut-off points of 77 and 86 ml/min respectively. E/eG ratio was useful for prediction of recovery in patients with AKI. NGAL best diagnosed AKI by keGFR and E/eG ratio. 2018-11-22 Monograph NonPeerReviewed application/pdf en http://irep.iium.edu.my/67922/1/Profile%20of%20Final%20Report_FRGS-15-235-0476.pdf Md Ralib, Azrina and Mat Nor, Mohd Basri and Mohamed, Rozilah @ Abdul Hadi and Abdullah, Norzamzila and Jamaludin, Ummu Kulthum and Dzaharudin, Fatimah (2018) Development of glomerular filtration rate monitor based on creatinine kinetic modelling in critically ill patients. Research Report. UNSPECIFIED. (Unpublished)
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) Md Ralib, Azrina Mat Nor, Mohd Basri Mohamed, Rozilah @ Abdul Hadi Abdullah, Norzamzila Jamaludin, Ummu Kulthum Dzaharudin, Fatimah Development of glomerular filtration rate monitor based on creatinine kinetic modelling in critically ill patients
description	Background: Creatinine kinetic denotes that under steady state, creatinine production (G) equals to creatinine excretion rate (E), and if production exceeds excretion, GFR is impaired. Kinetic estimate of GFR (keGFR) offers a more accurate estimate of GFR in the acute settings with rapidly changing kidney functions. Objectives: We evaluated keGFR and E/eG ratio in diagnosis of AKI and its recovery. We also compared their diagnostic ability to the plasma Cystatin C and NGAL. Methods: This was a prospective observational study of critically ill patients. Inclusion criteria were patients >18 years old with sepsis and procalcitonin>0.5ng/ml. Results: 70 patients were recruited. keGFR had the least bias with the mean differences nearest to zero (-18 ml/min) when compared to CrCl. keGFRCr and keGFRCysC were strongly diagnostic of AKI with AUC of 0.93 (0.87 to 0.99). In 39 patients with AKI, 15 recovered within 3 days. In these cases, E/eG ratio strongly predicted AKI recovery (AUC 0.83 (0.69 to 0.97)). The AUC of plasma NGAL were highest for AKI diagnosed by keGFR on Day 1 and Day 2, and by E/eG ratio on Day 3. Conclusions: In critically ill patients with sepsis, keGFRCr and keGFRCysC had the least bias and fair precision when compared to CrCl. They diagnosed AKI with cut-off points of 77 and 86 ml/min respectively. E/eG ratio was useful for prediction of recovery in patients with AKI. NGAL best diagnosed AKI by keGFR and E/eG ratio.
format	Monograph
author	Md Ralib, Azrina Mat Nor, Mohd Basri Mohamed, Rozilah @ Abdul Hadi Abdullah, Norzamzila Jamaludin, Ummu Kulthum Dzaharudin, Fatimah
author_facet	Md Ralib, Azrina Mat Nor, Mohd Basri Mohamed, Rozilah @ Abdul Hadi Abdullah, Norzamzila Jamaludin, Ummu Kulthum Dzaharudin, Fatimah
author_sort	Md Ralib, Azrina
title	Development of glomerular filtration rate monitor based on creatinine kinetic modelling in critically ill patients
title_short	Development of glomerular filtration rate monitor based on creatinine kinetic modelling in critically ill patients
title_full	Development of glomerular filtration rate monitor based on creatinine kinetic modelling in critically ill patients
title_fullStr	Development of glomerular filtration rate monitor based on creatinine kinetic modelling in critically ill patients
title_full_unstemmed	Development of glomerular filtration rate monitor based on creatinine kinetic modelling in critically ill patients
title_sort	development of glomerular filtration rate monitor based on creatinine kinetic modelling in critically ill patients
publishDate	2018
url	http://irep.iium.edu.my/67922/ http://irep.iium.edu.my/67922/1/Profile%20of%20Final%20Report_FRGS-15-235-0476.pdf
first_indexed	2023-09-18T21:36:26Z
last_indexed	2023-09-18T21:36:26Z
_version_	1777412851994984448

Development of glomerular filtration rate monitor based on creatinine kinetic modelling in critically ill patients

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