Prevalence and prediction of augmented renal clearance in the neurocritical care population
Background Augmented renal clearance (ARC; creatinine clearance [CrCl] >130 mL/min/1.73 m2) is prevalent in patients with neurological injuries and may influence their exposure to important pharmacological therapies. Little is known about the relationship between estimated and measured CrCl in th...
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ftdoajarticles:oai:doaj.org/article:1c61ad1ed8b94934936e2f912782fba8 2023-06-11T04:09:14+02:00 Prevalence and prediction of augmented renal clearance in the neurocritical care population Aaron M. Cook David Li Melissa A. Nestor Melissa L. Thompson Bastin 2022-12-01T00:00:00Z https://doi.org/10.18700/jnc.220061 https://doaj.org/article/1c61ad1ed8b94934936e2f912782fba8 EN KO eng kor The Korean Neurocritical Care Society http://www.e-jnc.org/upload/pdf/jnc-220061.pdf https://doaj.org/toc/2005-0348 https://doaj.org/toc/2508-1349 2005-0348 2508-1349 doi:10.18700/jnc.220061 https://doaj.org/article/1c61ad1ed8b94934936e2f912782fba8 Journal of Neurocritical Care, Vol 15, Iss 2, Pp 96-103 (2022) stroke aneurysmal subarachnoid hemorrhage pharmacokinetics traumatic brain injury Neurology. Diseases of the nervous system RC346-429 article 2022 ftdoajarticles https://doi.org/10.18700/jnc.220061 2023-05-28T00:37:11Z Background Augmented renal clearance (ARC; creatinine clearance [CrCl] >130 mL/min/1.73 m2) is prevalent in patients with neurological injuries and may influence their exposure to important pharmacological therapies. Little is known about the relationship between estimated and measured CrCl in this population. Methods This single-center, prospective, observational cohort study aimed to describe the association between ARC and estimated CrCl and neurological outcomes in a broad neurocritical care population. Prospective patient screening criteria included adults aged 18–85 years, with critical illness due to neurologic causes (such as ischemic stroke or subarachnoid hemorrhage) and lack of renal dysfunction on admission. Patients who had at least one urine CrCl measurement performed within the first 7 days of hospitalization were included. Two cohorts were evaluated: those with ARC and those without ARC. Results Fifty-seven patients were included, of whom 49 (86%) exhibited ARC. Subjects with ARC were more likely to be male and had a significantly higher median measured CrCl (201.7 mL/min/1.73 m2) than those without ARC (109.8 mL/min/1.73 m2). The Augmented Renal Clearance in Trauma Intensive Care (ARCTIC) score displayed the strongest association (vs. CrCl equations) with ARC development (area under the receiver operating characteristic curve, 0.648). Conclusion The prevalence of ARC in the present study of a broad neurocritical care population appeared to be high (86%). The ARCTIC score had higher sensitivity and specificity for diagnosing ARC than the common serum creatinine-based estimation. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Journal of Neurocritical Care 15 2 96 103 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English Korean |
topic |
stroke aneurysmal subarachnoid hemorrhage pharmacokinetics traumatic brain injury Neurology. Diseases of the nervous system RC346-429 |
spellingShingle |
stroke aneurysmal subarachnoid hemorrhage pharmacokinetics traumatic brain injury Neurology. Diseases of the nervous system RC346-429 Aaron M. Cook David Li Melissa A. Nestor Melissa L. Thompson Bastin Prevalence and prediction of augmented renal clearance in the neurocritical care population |
topic_facet |
stroke aneurysmal subarachnoid hemorrhage pharmacokinetics traumatic brain injury Neurology. Diseases of the nervous system RC346-429 |
description |
Background Augmented renal clearance (ARC; creatinine clearance [CrCl] >130 mL/min/1.73 m2) is prevalent in patients with neurological injuries and may influence their exposure to important pharmacological therapies. Little is known about the relationship between estimated and measured CrCl in this population. Methods This single-center, prospective, observational cohort study aimed to describe the association between ARC and estimated CrCl and neurological outcomes in a broad neurocritical care population. Prospective patient screening criteria included adults aged 18–85 years, with critical illness due to neurologic causes (such as ischemic stroke or subarachnoid hemorrhage) and lack of renal dysfunction on admission. Patients who had at least one urine CrCl measurement performed within the first 7 days of hospitalization were included. Two cohorts were evaluated: those with ARC and those without ARC. Results Fifty-seven patients were included, of whom 49 (86%) exhibited ARC. Subjects with ARC were more likely to be male and had a significantly higher median measured CrCl (201.7 mL/min/1.73 m2) than those without ARC (109.8 mL/min/1.73 m2). The Augmented Renal Clearance in Trauma Intensive Care (ARCTIC) score displayed the strongest association (vs. CrCl equations) with ARC development (area under the receiver operating characteristic curve, 0.648). Conclusion The prevalence of ARC in the present study of a broad neurocritical care population appeared to be high (86%). The ARCTIC score had higher sensitivity and specificity for diagnosing ARC than the common serum creatinine-based estimation. |
format |
Article in Journal/Newspaper |
author |
Aaron M. Cook David Li Melissa A. Nestor Melissa L. Thompson Bastin |
author_facet |
Aaron M. Cook David Li Melissa A. Nestor Melissa L. Thompson Bastin |
author_sort |
Aaron M. Cook |
title |
Prevalence and prediction of augmented renal clearance in the neurocritical care population |
title_short |
Prevalence and prediction of augmented renal clearance in the neurocritical care population |
title_full |
Prevalence and prediction of augmented renal clearance in the neurocritical care population |
title_fullStr |
Prevalence and prediction of augmented renal clearance in the neurocritical care population |
title_full_unstemmed |
Prevalence and prediction of augmented renal clearance in the neurocritical care population |
title_sort |
prevalence and prediction of augmented renal clearance in the neurocritical care population |
publisher |
The Korean Neurocritical Care Society |
publishDate |
2022 |
url |
https://doi.org/10.18700/jnc.220061 https://doaj.org/article/1c61ad1ed8b94934936e2f912782fba8 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Journal of Neurocritical Care, Vol 15, Iss 2, Pp 96-103 (2022) |
op_relation |
http://www.e-jnc.org/upload/pdf/jnc-220061.pdf https://doaj.org/toc/2005-0348 https://doaj.org/toc/2508-1349 2005-0348 2508-1349 doi:10.18700/jnc.220061 https://doaj.org/article/1c61ad1ed8b94934936e2f912782fba8 |
op_doi |
https://doi.org/10.18700/jnc.220061 |
container_title |
Journal of Neurocritical Care |
container_volume |
15 |
container_issue |
2 |
container_start_page |
96 |
op_container_end_page |
103 |
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1768383005100867584 |