• Jan J De Waele, Kirsten Colpaert, Johan Decruyenaere, Barbara O M Claus, and Hugo Robays.
• Pharmacy Department, Ghent University Hospital, Pharmacy, 9000 Ghent, Belgium. Electronic address: Barbara.Claus@UZGENT.be.
• J Crit Care. 2013 Oct 1;28(5):695-700.

IntroductionWe describe incidence and patient factors associated with augmented renal clearance (ARC) in adult intensive care unit (ICU) patients.Materials And MethodsA prospective observational study in a mixed cohort of surgical and medical ICU patients receiving antimicrobial therapy at the Ghent University Hospital, Belgium. Kidney function was assessed by the 24-hour creatinine clearance (Ccr); ARC defined as at least one Ccr of >130 mL/min per 1.73 m2. Multivariate logistic regression analysis: to assess variables associated with ARC occurrence. Therapeutic failure (TF): an impaired clinical response and need for alternate antimicrobial therapy.ResultsOf the 128 patients and 599 studied treatment days, ARC was present in 51.6% of the patients. Twelve percent permanently expressed ARC. ARC patients had a median Ccr of 144 mL/min per 1.73 m2 (IQR 98-196). Median serum creatinine concentration on the first day of ARC was 0.54 mg/dL (IQR 0.48-0.69). Patients with ARC were significantly younger (P<.001). Age and male gender were independently associated with ARC whereas the APACHE II score was not. ARC patients had more TF (18 (27.3%) vs. 8 (12.9%); P=.04).ConclusionARC was documented in approximately 52% of a mixed ICU patient population receiving antibiotic treatment with worse clinical outcome. Young age and male gender were independently associated with ARC presence.Copyright © 2013 Elsevier Inc. All rights reserved.

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