- Nephrology
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Measured versus estimated creatinine clearance in critically ill patients with acute kidney injury: an observational study
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Sara Kadivarian, Fatemeh Heydarpour, Hasanali Karimpour, Foroud Shahbazi
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Acute Crit Care. 2022;37(2):185-192. Published online April 22, 2022
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DOI: https://doi.org/10.4266/acc.2021.01256
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 Abstract
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- Background
Acute kidney injury (AKI) commonly occurs in critically ill patients. Estimation of renal function and antibiotics dose adjustment in patients with AKI is a challenging issue.
Methods
Urinary creatinine clearance was measured in a 6-hour urine collection from patients with acute kidney injuries. The correlations between different formulas including the modified Cockcroft-Gault, modification of diet in renal disease, chronic kidney disease-epidemiology collaboration, Jelliffe, kinetic-glomerular filtration rate (GFR), Brater, and Chiou formulas were considered. The pattern of the prescribed antimicrobial agents was also compared with the patterns in the available resources.
Results
Ninety-five patients with acute kidney injuries were included in the research. The mean age of the participants was 63.11±17.58 years old. The most patients (77.89%) were in stage 1 of AKI according to the Acute Kidney Injury Network criteria, followed by stage 2 (14.73%) and stage 3 (7.36), respectively. None of the formulations had a high or very high correlation with the measured creatinine clearance. In stage 1, Chiou (r=0.26), and in stage 2 and 3, kinetic-GFR (r=0.76 and r=0.37) had the highest correlation coefficient. Antibiotic over- and under-dosing were frequently observed in the study.
Conclusions
The results showed that none of the static methods can predict the measured creatinine clearance in the critically ill patients. The dynamic methods such as kinetic-GFR can be helpful for patients who do not receive diuretics and vasopressors. Further studies are needed to confirm our results.
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Citations
Citations to this article as recorded by  - SWOT and Root Cause Analyses of Antimicrobial Resistance to Oral Antimicrobial Treatment of Cystitis
Pradeep Tyagi, Shachi Tyagi, Laurence Stewart, Scott Glickman
Antibiotics.2024; 13(4): 328. CrossRef - Prospective Comparison of Urinary Measured Creatinine Clearance With eGFR and Cystatin C Based Cis-eGFR, Including Kinetic eGFR in the Immediate Post-transplant Period With Prompt Allograft Function
Ashokkumar Jain, Umar Farooq, Nasrollah Ghahramani, Deborah Daoud, Eileen Swartz, Christopher Hamilton, Alireza Vafaei Sadr, Thomas Butler
Transplantation Proceedings.2024; 56(6): 1319. CrossRef - Development and validation of a deep learning algorithm for the prediction of serum creatinine in critically ill patients
Ghodsieh Ghanbari, Jonathan Y Lam, Supreeth P Shashikumar, Linda Awdishu, Karandeep Singh, Atul Malhotra, Shamim Nemati, Zaid Yousif
JAMIA Open.2024;[Epub] CrossRef - Estimated glomerular filtration rates are higher when creatinine‐based equations are compared with a cystatin C‐based equation in coronavirus disease 2019
Anders O. Larsson, Michael Hultström, Robert Frithiof, Miklos Lipcsey, Ulf Nyman, Mats B. Eriksson
Acta Anaesthesiologica Scandinavica.2023; 67(2): 213. CrossRef - Selection of appropriate reference creatinine estimate for acute kidney injury diagnosis in patients with severe trauma
Kangho Lee, Dongyeon Ryu, Hohyun Kim, Sungjin Park, Sangbong Lee, Chanik Park, Gilhwan Kim, Sunhyun Kim, Nahyeon Lee
Acute and Critical Care.2023; 38(1): 95. CrossRef
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