Abstract
Objective
To assess the accuracy of 4 mathematical equations used to estimate creatinine clearance versus the 24-h creatinine clearance in ICU patients.
Design
Prospective study of renal function prediction.
Setting
The general adult ICUs of 3 metropolitan hospitals.
Patients
199 critically ill patients with indwelling foley catheters.
Intervention and measurements
Routine 24 h creatinine clearances were evaluated only in patients whose urine volume recorded by the nurses was within 10% of the laboratory's measured volume. Four mathematical equations utilizing age, sex, body weight, height, and plasma creatinine were used as a comparison. There was no difference in estimated creatinine clearance by 3 published methods when the 24 h creatinine clearance exceeded 100 ml/min. When the 24 h creatinine clearance was less than 100 ml/min, however, one prediction equation adjusted for lean body weight (LBW), was the most accurate. This equation accurately predicted creatinine clearance in the range of 30–100 ml/min and slightly overestimated creatinine clearance at 0–30 ml/min (p<0.01, ANOVA all groups,p<0.05 Fisher and Scheffé post-hoc tests) with a mean difference ±95% confidence interval of −5±3.1 ml/min.
Conclusion
An initial rapid estimate of creatinine clearance in critically ill ICU patients with reduced renal function can be determined by an equation adjusted for LBW.
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Pesola, G.R., Akhavan, I., Madu, A. et al. Prediction equation estimates of creatinine clearance in the intensive care unit. Intensive Care Med 19, 39–43 (1993). https://doi.org/10.1007/BF01709276
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DOI: https://doi.org/10.1007/BF01709276