PMID: 9164151Feb 1, 1997Paper

Measurements of glomerular filtration in the intensive care unit are only a rough guide to renal function

South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
M Wells, J Lipman

Abstract

An estimate of glomerular filtration rate (GFR) is important in intensive care units (ICUs) to individualize drug dosages, and for the early detection of acute renal failure (ARF). Creatinine clearance or calculations based on plasma creatinine are the most widely used indicators of GFR, but may be very inaccurate in critically ill patients. We have assessed the accuracy of predictions of GFR by creatinine clearance and plasma creatinine in critically ill patients with variable creatinine kinetics. This is a retrospective record review set in a 24-bed multidisciplinary ICU. Eighteen patient records (9 normal renal function, 9 with ARF-250 patient days) were evaluated. Creatinine clearance measured daily over an 8-hour period, plasma creatinine, creatinine production and 8-hourly urine output were recorded for each day of ICU stay. The discrepancy between measured creatinine clearance and creatinine clearance predicted by the Cockcraft-Gault equation was determined. The coefficient of variation (CV) for each of the contributing variables and the final inherent error for the estimation of GFR were determined. The difference between measured and predicted creatinine clearance was large (predicted GFR may be from 60 ml/min above to...Continue Reading

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