Comparative analysis of two-hour creatinine clearance and the C-G formula for renal function assessment in critically ill patients

Le résumé fourni par la source

Objective and rationale To investigate if the 2-hour creatinine clearance (Ccr 2 ) provides a more precise and timely assessment of renal function in critically ill patients compared to the Cockcroft-Gault formula (Cr C-G ). Materials and Methods This cohort study incorporated 74 patients who were hospitalized for more than 48 hours in the Intensive Care Unit over 6 months. A 24-hour urine collection protocol was observed, and concurrently, 316 two-hour urine specimens were obtained. Then calculated and analyzed the correlation and consistency between Ccr 2 , Cr C-G , and 24-hour creatinine clearance (Ccr 24 ) values. The rates of change in Ccr 2 (ΔCcr 2 ) and Cr C-G (ΔCr C-G ) were compared over two consecutive samples. Results The R-values of Ccr 2 and Ccr 24 in the early, middle and late 24 hours were 0.640, 0.886 and 0.854 (P<0.001), with biases of -2.1, 1.7, and 6.3 ml/min/1.73m 2 , respectively. Meanwhile, the R-values for Cr C-G and Ccr 24 at these time points were 0.618, 0.822, and 0.828(P<0.001), with biases of -14.0, -5.2, and -1.8 ml/min/1.73m 2 , respectively. For patients with Ccr 24 ≥60 ml/min/1.73m 2 , the R-value of Ccr 2 and Ccr 24 during the middle two hours was 0.852(P<0.001), while the R-values for Cr C-G and Ccr 24 were 0.763(P<0.001), with biases of -2.3 ml/min/1.73m 2 and -14.2 ml/min/1.73m 2 respectively. For the group with Ccr 24 ≥ 120 ml/min/1.73m 2 (n=72), both Ccr 2 and Ccr 24 displayed a statistically significant elevation compared to Cr C-G (P < 0.001), yet no significant difference was observed between Ccr 2 and Ccr 24 (P = 0.289). Out of 50 patients, 46(92%) experienced a ΔCcr 2 ≥20% at least once, compared to 20(40%) with a ΔCr C-G ≥20%(P<0.001). 25(50%) with a ΔCcr 2 ≥50%, compared to 3(6%) with a ΔCr C-G ≥50%(P<0.001). Conclusion Ccr 2 demonstrates a more accurate and more timely indicator of renal function in critically ill patients than Cr C-G .

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.