Critical Illness Clinical Trial
Official title:
Detailed Assessment of Augmented Renal Clearance in a Large Mixed Intensive Care Unit Population
This multi-center retrospective cohort study presents a detailed assessment of augmented renal clearance (ARC) in a mixed population of adult critically ill patients. Epidemiology of ARC will be studied in detail in a very heterogeneous population. Risk factors for ARC will be identified and a predictive scoring system for ARC ready to use in clinical practice will be constructed and validated. Performance of estimators of kidney function will be measured and a cutoff for ARC will be determined for the best estimator. Finally clinical impact of ARC will be explored using vancomycine and aminoglycosides levels as surrogate marker.
Augmented renal clearance will be assessed in detail in a very large and heterogeneous adult
critically ill population. Analysis will be conducted retrospectively on a multi-center
database collected by the M@tric research group. M@tric collects data from all intensive care
units (surgical, medical, cardiac) in 3 Belgian University Hospitals (Leuven, Ghent,
Antwerp).
Anonymised admission, demographic, clinical and laboratory data collected from 2013 until the
present will be retrieved from the M@tric database. These data will then be coded and
analysed in R statistical software. ARC will be defined based on a 24h creatinine clearance
(CrCl24h) >=130ml/min/1.73m².
Epidemiology and risk factors for ARC will be studied in order to confirm and clarify past
studies which have mostly been done in rather small and specific subsets of patients. A
predictive algorithm for ARC will be trained and subsequently validated for use in clinical
practice. Moreover this algorithm will be compared to existing scoring systems, which have
not yet found their way into clinical practice. This algorithm will provide the ability to
anticipate ARC on the intensive care unit. Also use of formulae estimating renal function
will be evaluated in this population. These estimators will be compared to the CrCl24h, which
is considered the golden standard in clinical practice. A cutoff for the best estimating
formula in order to detect ARC will be calculated. Finally the impact of ARC on serum levels
of hydrophilic molecules likes vancomycine and aminoglycosides will be studied. As this
research follows a retrospective design these levels will be used a surrogate marker for
clinical impact. This will potentially point out some opportunities for future research on
the clinical impact of ARC.
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