IP Journal of Urology, Nephrology and Hepatology Science

Comparison of CKD-EPI estimated glomerular filtration rate and measured creatinine clearance in critically ill patients with normal plasma creatinine

Full Text PDF

Article Type : Original Article

Author Details: Ashith Shettian*,Uday B. Nayak

Volume : 2

Issue : 1

Online ISSN : XXXX

Print ISSN : XXXX

Article First Page : 1

Article End Page : 5

Abstract

Introduction: Accurate assessment of renal function is a priority in the management of critically ill patients. Assessment of renal function helps in guiding drug dosing, optimize fluid, acid–base, and electrolyte management. Evidence based medicine in the form of research studies have shown that there exists a poor correlation between CKD-EPI eGFR and creatinine clearance in patients with normal plasma creatinine. Currently there is a paucity of data in India as to whether examining whether eGFR could be used in place of conventional measures for such a purpose, particularly in the critical care environment. The study was done to compare CKD-EPI eGFR with measured urinary CLCR, in recently admitted critically ill patients with normal plasma creatinine concentrations.
Material and Methods: The study was a prospective observational study which consisted of recently admitted critically ill patients with normal plasma creatinine concentrations admitted to the ICU of A. J. Institute Of Medical Sciences Hospital, Mangalore on f 100 patients who met a pre-defined criteria done over a period of 2 years from October 2014 to November 2016 after obtaining ethical clearance committee of the institution and informed consent of the patient and/or their legal heir. This was a prospective observational study that was conducted in the intensive care unit Patients who were recently were admitted to the intensive ICU admission, plasma creatinine concentration
Results: The mean age in our study was 55.43 years, the mean height was 164.55cms, the mean weight was 69.19 kg and the mean BSA was1.7759 males predominated the study cases 62%. males predominated the study cases 62%.16 % cases in our study needed mechanical ventilation On comparison of the mean values of 24 HR Cr CL and CKD-EPI the mean values of CKD-EPI is higher with a difference of 0.9727 is statistically not significant with a p value of 0.726. At a GFR of 90-119.99 ml/min On comparison of the mean values of 24 HR Cr CL and CKD-EPI the mean values of 24 HR Cr CL is higher with a difference of 22.229 is statistically significant with a p value of <0>
Conclusion: In conclusion, this study has examined CKD-EPI eGFR in comparison to 8-hr measured CLCR in a cohort of recently admitted critically ill patients with normal plasma CR concentrations. Our results suggest poor agreement between these techniques in this population. Whether this represents a true limitation of CKD-EPI eGFR, or an intuitive discrepancy based on the problems with endogenous CLCR, remains uncertain. Notwithstanding this, until additional data are available on the utility of CKD-EPI eGFR for drug dose adjustment, particularly in identifying ARC, we would recommend clinicians consider using CLCR for this purpose.

Keywords: Glomerular filtration rate, Renal Disease, CKD-EPI.

Doi No:-10.18231