Abstract：
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.
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.
摘要：
背景：急性肾损伤（AKI）通常发生在危重患者中。评估AKI患者的肾功能和抗生素剂量调整是一个具有挑战性的问题。
方法：在急性肾损伤患者的6小时尿液中测量尿肌酐清除率。不同公式之间的相关性，包括修改后的Cockcroft-Gault，肾脏疾病的饮食调整，慢性肾脏病-流行病学合作，Jelliffe,动态肾小球滤过率（GFR），Brater,并考虑了Chiou公式。还将规定的抗微生物剂的模式与可用资源中的模式进行了比较。
结果：95例急性肾损伤患者被纳入研究。参与者的平均年龄为63.11±17.58岁。根据急性肾损伤网络标准，大多数患者（77.89%）处于AKI的1期，其次是阶段2(14.73%)和阶段3(7.36)，分别。没有一种制剂与测量的肌酸酐清除率具有高或非常高的相关性。在阶段1中，Chiou（r=0.26），在第2阶段和第3阶段，动力学GFR（r=0.76和r=0.37）具有最高的相关系数。在研究中经常观察到抗生素过量和剂量不足。
结论：结果显示，没有一种静态方法可以预测危重患者的肌酐清除率。动力学GFR等动态方法对不接受利尿剂和血管加压药的患者可能有帮助。需要进一步的研究来证实我们的结果。
方法：在急性肾损伤患者的6小时尿液中测量尿肌酐清除率。不同公式之间的相关性，包括修改后的Cockcroft-Gault，肾脏疾病的饮食调整，慢性肾脏病-流行病学合作，Jelliffe,动态肾小球滤过率（GFR），Brater,并考虑了Chiou公式。还将规定的抗微生物剂的模式与可用资源中的模式进行了比较。
结果：95例急性肾损伤患者被纳入研究。参与者的平均年龄为63.11±17.58岁。根据急性肾损伤网络标准，大多数患者（77.89%）处于AKI的1期，其次是阶段2(14.73%)和阶段3(7.36)，分别。没有一种制剂与测量的肌酸酐清除率具有高或非常高的相关性。在阶段1中，Chiou（r=0.26），在第2阶段和第3阶段，动力学GFR（r=0.76和r=0.37）具有最高的相关系数。在研究中经常观察到抗生素过量和剂量不足。
结论：结果显示，没有一种静态方法可以预测危重患者的肌酐清除率。动力学GFR等动态方法对不接受利尿剂和血管加压药的患者可能有帮助。需要进一步的研究来证实我们的结果。
