Translational and Clinical Pharmacology

  • 제26권3호
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  • Pages.111-114
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  • 2018
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  • 2289-0882(pISSN)
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  • 2383-5427(eISSN)
대한임상약리학회 (Korean Society for Clinical Pharmacology and Therapeutics)
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Augmented renal clearance

  • Atkinson, Arthur J. Jr. (Department of Pharmacology, Feinberg School of Medicine, Northwestern University)
  • 발행 : 2018.09.15
⟨ 이전 논문 다음 논문 ⟩

초록

Adding to the complexity of caring for critically ill patients is the fact that many of them have a creatinine clearance that exceeds $130mL/min/1.73m^2$. This phenomenon, termed augmented renal clearance (ARC), has only recently been widely recognized and its pathogenesis remains incompletely understood. However, ARC has been shown to result in increased dose requirements for drugs that are primarily eliminated by renal excretion, including many antimicrobial agents and enoxaparin. Recognition of ARC is hampered by the fact that the standard creatinine-based equations used to estimate renal function are not accurate in this clinical setting and the diagnosis is best established using both serum and urine creatinine measurements to calculate clearance. So a high index of clinical suspicion and awareness is usually required before this step is taken to confirm the diagnosis of ARC.

키워드

참고문헌

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피인용 문헌

  1. Case Report: Subtherapeutic Vancomycin and Meropenem Concentrations due to Augmented Renal Clearance in a Patient With Intracranial Infection Caused by Streptococcus intermedius vol.12, pp.None, 2018, https://doi.org/10.3389/fphar.2021.728075
  2. Key Challenges in Providing Effective Antibiotic Therapy for Critically Ill Patients with Bacterial Sepsis and Septic Shock vol.109, pp.4, 2018, https://doi.org/10.1002/cpt.2203
  3. Population Pharmacokinetics and Outcomes of Critically Ill Pediatric Patients Treated with Intravenous Colistin at Higher Than Recommended Doses vol.65, pp.6, 2018, https://doi.org/10.1128/aac.00002-21
  4. Population Pharmacokinetic Modeling and Simulations of Imipenem in Burn Patients With and Without Continuous Venovenous Hemofiltration in the Military Health System vol.61, pp.9, 2018, https://doi.org/10.1002/jcph.1865
  5. Population Pharmacokinetics of Levetiracetam and Dosing Evaluation in Critically Ill Patients with Normal or Augmented Renal Function vol.13, pp.10, 2018, https://doi.org/10.3390/pharmaceutics13101690
  6. The impact of early target attainment of vancomycin in critically ill patients with confirmed Gram-positive infection: A retrospective cohort study vol.21, pp.1, 2018, https://doi.org/10.1186/s12879-021-06840-y