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Ann Fr Anesth Reanim · May 2014
Comparative StudyComparative study of three methods of estimation of creatinine clearance in critically ill patients.
- V Blasco, F Antonini, L Zieleskiewicz, E Hammad, J Albanèse, C Martin, and M Leone.
- Service d'anesthésie et de réanimation, hôpital Nord, Assistance publique-Hôpitaux de Marseille, Aix-Marseille université, chemin des Bourrely, 13015 Marseille, France.
- Ann Fr Anesth Reanim. 2014 May 1;33(5):e85-8.
BackgroundAt the bedside, the reference method for creatinine clearance determination is based on the measurement of creatinine concentrations in urine and serum (mCrCl). Several models are available to calculate the creatinine clearance from the serum creatinine concentration. This observational survey aimed at testing the hypothesis that the proposed equations are unreliable to determine accurate creatinine clearance in patients admitted to intensive care unit (ICU).MethodCreatinine clearance was determined by the use of mCrCl. Then, we compared three equations: Cockcroft-Gault (CG), Simplified Modification of Diet in Renal Disease (MDRDs), and Chronic Kidney Disease Epidemiology (CKD-EPI) in 156 consecutive patients within the first 24hours after ICU admission. We tested the hypothesis that the three equations were equivalent. The agreement between the three equations was evaluated by linear regression and Bland and Altman analysis.ResultsBland and Altman analysis showed similar agreement between the three equations. The biases and precisions were -4.8±51, -1.3±50, and 8.2±44 for CG, MDRDs, and CKD-EPI equations, respectively (P>0.05). The precisions were similar for the three equations (P>0.05). The percentages of outliers at ±30% were 44%, 45%, and 49% for CG, MDRDs, and CKD-EPI, respectively (P>0.05).ConclusionRegarding the high percentage of outliers, the use of these equations cannot be recommended in ICU patients.Copyright © 2014 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.
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