Comparison of Aminoglycoside Clearance and Calculated Serum Creatinine Clearances

Deeter, Robert; Krauss, Elliot A.; Penn, Frederick; Nahaczewski, Ann E.

doi:10.1097/00007691-198903000-00006

Cited by 12 publications

(4 citation statements)

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“…As reported previously 9,12,20,[28][29][30]32 , the mean gentamicin Vd in ICU patients was >0.25 l/kg and given the variability (0.18 to 0.71 l/kg) and that 40% had a Vd >0.3 l/kg, it would appear prudent to assume a Vd of at least 0.3 l/kg until the actual value is known. Increases in Vd have been reported before in association with clinical situations including sepsis 12,[31][32] , though this is not a consistent finding 29 .…”

Section: Discussionsupporting

confidence: 57%

“…Aminoglycosides might be used to estimate renal function because they are freely filtered, neither secreted or reabsorbed in the kidney and have little non-renal clearance. Studies comparing aminoglycoside clearance to estimates of CrCl in ICU patients have been conflicting, finding either good 9,20,21 or poor correlation 22 . Studies comparing aminoglycoside clearance with other non-invasive estimates of renal function used in the ICU have not been recently conducted.…”

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confidence: 99%

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Aminoglycoside Clearance is a Good Estimate of Creatinine Clearance in Intensive Care Unit Patients

Jones

Peter

Field

2009

Anaesth Intensive Care

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The aim of this study was to determine whether creatinine clearance can be estimated as well by clearance of gentamicin/tobramycin as by routine, non-invasive estimates in the intensive care unit. The volume of distribution and clearance values for gentamicin/tobramycin were obtained using first order kinetics and an estimate of creatinine clearance derived. Seven estimates of renal function (Cockroft-Gault, MDRD4 and MDRD6 equations, two-and 24-hour urine estimates, two equations utilising Cystatin C concentrations) were compared to the gentamicin/tobramycin clearance estimate in 100 intensive care unit patients. The gentamicin clearance estimate was at least as reliable as other estimates. The two-hour was less reliable than the 24-hour urine estimate. The Cockroft-Gault appeared to out-perform the MDRD equation estimates. The MDRD4 was not as reliable as the MDRD6 estimate. Cystatin C estimates appeared not as reliable as the gentamicin estimate of renal function. The gentamicin/tobramycin estimate is at least as good as other estimates and it is available sooner than most others. It should be used in all patients who are prescribed gentamicin. The two-hour urine and MDRD4 estimates should not be used in the intensive care unit.

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Section: Discussionsupporting

confidence: 57%

mentioning

confidence: 99%

Aminoglycoside Clearance is a Good Estimate of Creatinine Clearance in Intensive Care Unit Patients

Jones

Peter

Field

2009

Anaesth Intensive Care

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“…During resolution, drug clearance estimated from TDM may be used in the assessment of kidney function. For example, the clearance of aminoglycosides and vancomycin correlate well with creatinine clearance [50, 51]. Estimation of clearance of these drugs by TDM may assist the clinician in dosing other drugs that are not monitored (e.g.…”

Section: Renal Supportmentioning

confidence: 99%

The 6R’s of drug induced nephrotoxicity

2017

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Drug induced kidney injury is a frequent adverse event which contributes to morbidity and increased healthcare utilization. Our current knowledge of drug induced kidney disease is limited due to varying definitions of kidney injury, incomplete assessment of concurrent risk factors and lack of long term outcome reporting. Electronic surveillance presents a powerful tool to identify susceptible populations, improve recognition of events and provide decision support on preventative strategies or early intervention in the case of injury. Research in the area of biomarkers for detecting kidney injury and genetic predisposition for this adverse event will enhance detection of injury, identify those susceptible to injury and likely mitigate risk. In this review we will present a 6R framework to identify and mange drug induced kidney injury – risk, recognition, response, renal support, rehabilitation and research.

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“…Gentamycin clearance performed the best, being within 10% of the value on 44% of occasions and within 20% on 78% of occasions. Gentamycin clearance has previously been shown to be a better estimate of creatinine clearance than the 24-h urine estimate in a study using inulin as the comparator [ 63 – 66 ]. Giving aminoglycosides for the estimation of renal function alone may not be a wise option but in patients who are therapeutically prescribed aminoglycosides, their clearance may serve as one of the better options in estimating renal function.…”

Section: Reviewmentioning

confidence: 99%

Estimation of renal function in the intensive care unit: the covert concepts brought to light

et al. 2014

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Frantic efforts have been made up to this date to derive consensus for estimating renal function in critically ill patients, only to open the Pandora's box. This article tries to explore the various methods available to date, the newer concepts, and the uncared issues that may still prove to be useful in estimating renal function in intensive care unit patients. The concept of augmented renal clearance, which is frequently encountered in critically ill patients, should always be taken into account, as correct therapeutic dosage of drugs sounds vital which in turn depends on correctly calculated glomerular filtration rate. Serum creatinine and creatinine-based formulae have their own demerits that are well known and established. While Cockcroft-Gault and 4-variable modification of diet in renal diseases formulae are highly inadequate in the intensive care setup for estimating glomerular filtration rate, employing isotopic methods is impractical and cumbersome. The 6-variable modification of diet in renal diseases formula fairs better as it takes into account the serum albumin and blood urea nitrogen, too. Jelliffe's and modified Jelliffe's equations take into account the rate of creatinine production and volume of distribution which in turn fluctuates heavily in a critically ill patient. Twenty-four-hour and timed creatinine clearances offer values close to reality although not accurate and cannot provide immediate results. Cystatin C is a novel agent that offers a sure promise as it is least influenced by factors that affect serum creatinine to a major extent. Aminoglycoside clearance, although still in the dark area, may prove a simple yet precise way of estimating glomerular filtration rate in those patients in whom these drugs are therapeutically employed. Optic ratiometric method has emerged as the most sophisticated one in glomerular filtration rate estimation in critically ill patients.

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Comparison of Aminoglycoside Clearance and Calculated Serum Creatinine Clearances

Cited by 12 publications

References 0 publications

Aminoglycoside Clearance is a Good Estimate of Creatinine Clearance in Intensive Care Unit Patients

Aminoglycoside Clearance is a Good Estimate of Creatinine Clearance in Intensive Care Unit Patients

The 6R’s of drug induced nephrotoxicity

Estimation of renal function in the intensive care unit: the covert concepts brought to light

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