Research advances in augmented renal clearance in critically ill children
ZHOU Ran, FANG Yu-Ting, SU Dan
Department of Life Sciences and Medicine, First Affiliated Hospital of University of Science and Technology of China/Anhui Provincial Hospital, Hefei 230001, China
Abstract：In recent years, the concept of "augmented renal clearance" (ARC) has been proposed in the field of critical illness and is defined as enhanced renal clearance of drugs. ARC is considered when the creatinine clearance rate exceeds 130 mL/(min·1.73 m2). An increasing number of evidence has shown that ARC is commonly seen in critically ill adults and children. In critically ill children, low drug concentration due to ARC may lead to treatment failure. Unfortunately, ARC is often neglected due to the lack of reliable tools to assess renal function in critically ill children. Therefore, with reference to the articles on ARC in critically ill children, this article reviews the concept of ARC, the pathogenesis of ARC, the influencing factors for ARC, the identification tools for ARC, and the influence of ARC on pharmacokinetics/pharmacodynamics of antibacterial agents and clinical outcome, in order to provide a reference for clinical medication.
Benmaek F, Behforouz N, Benoist JF, et al. Renal effects of lowdose dopamine during vasopressor therapy for posttraumatic intracranial hypertension[J]. Intensive Care Med, 1999, 25(4):399-405.
[2]
Sime FB, Udy AA, Roberts JA. Augmented renal clearance in critically ill patients:etiology, definition and implications for beta-lactam dose optimization[J]. Curr Opin Pharmacol, 2015, 24:1-6.
[3]
Bilbao-Meseguer I, Rodríguez-Gascón A, Barrasa H, et al. Augmented renal clearance in critically ill patients:a systematic review[J]. Clin Pharmacokinet, 2018, 57(9):1107-1121.
[4]
Udy AA, Roberts JA, Lipman J. Implications of augmented renal clearance in critically ill patients[J]. Nat Rev Nephrol, 2011, 7(9):539-543.
[5]
Hirai K, Ihara S, Kinae A, et al. Augmented renal clearance in pediatric patients with febrile neutropenia associated with vancomycin clearance[J]. Ther Drug Monit, 2016, 38(3):393-397.
[6]
Avedissian SN, Bradley E, Zhang D, et al. Augmented renal clearance using population-based pharmacokinetic modeling in critically ill pediatric patients[J]. Pediatr Crit Care Med, 2017, 18(9):e388-e394.
[7]
Lee B, Kim J, Park JD, et al. Predicting augmented renal clearance using estimated glomerular filtration rate in criticallyill children[J]. Clin Nephrol, 2017, 88(9):148-155.
Sara S, Federico N, Mario M, et al. Intra-parenchymal renal resistive index variation (IRRIV) describes renal functional reserve (RFR):pilot study in healthy volunteers[J]. Front Physiol, 2016, 7(55):286.
[10]
Sharma A, Mucino MJ, Ronco C. Renal functional reserve and renal recovery after acute kidney injury[J]. Nephron Clin Pract, 2014, 127(1-4):94-100.
[11]
Hobbs AL, Shea KM, Roberts KM, et al. Implications of augmented renal clearance on drug dosing in critically ill patients:a focus on antibiotics[J]. Pharmacotherapy, 2015, 35(11):1063-1075.
[12]
De Cock PA, Standing JF, Barker CI, et al. Augmented renal clearance implies a need for increased amoxicillin/clavulanic acid dosing in critically ill children[J]. Antimicrob Agents Chemother, 2015, 59(11):7027-7035.
Fuster-Lluch O, Gerónimo-Pardo M, Peyró-García R, et al. Glomerular hyperfiltration and albuminuria in critically ill patients[J]. Anaesth Intensive Care, 2008, 36(5):674-680.
[15]
Delanaye P, Cavalier E, Pottel H. Serum creatinine:not so simple![J]. Nephron, 2017, 136(4):302-308.
[16]
Macedo E, Josée Bouchard, Soroko SH, et al. Fluid accumulation, recognition and staging of acute kidney injury in critically-ill patients[J]. Crit Care, 2010, 14(3):R82.
[17]
Udy AA, Morton FJ, Nguyenpham S, et al. A comparison of CKD-EPI estimated glomerular filtration rate and measured creatinine clearance in recently admitted critically ill patients with normal plasma creatinine concentrations[J]. BMC Nephrol, 2013, 14:250.
[18]
Barletta JF, Mangram AJ, Byrne M, et al. The importance of empiric antibiotic dosing in critically ill trauma patients:are we under-dosing based on augmented renal clearance and inaccurate renal clearance estimates?[J]. J Trauma Acute Care Surg, 2016, 81(6):1115-1121.
[19]
Ruiz S, Minville V, Asehnoune K, et al. Screening of patients with augmented renal clearance in ICU:taking into account the CKD-EPI equation, the age, and the cause of admission[J]. Ann Intensive Care, 2015, 5(1):49.
[20]
张敏.肾功能的评估方法及进展[J].解放军医学院学报, 2012, 33(6):690-692.
[21]
Steinke T, Moritz S, Beck S, et al. Estimation of creatinine clearance using plasma creatinine or cystatin C:a secondary analysis of two pharmacokinetic studies in surgical ICU patients[J]. BMC Anesthesiol, 2015, 15:62.
[22]
Adnan S, Ratnam S, Kumar S, et al. Select critically ill patients at risk of augmented renal clearance:experience in a Malaysian intensive care unit[J]. Anaesth Intensive Care, 2014, 42(6):715-722.
[23]
Udy AA, Jarrett P, Stuart J, et al. Determining the mechanisms underlying augmented renal drug clearance in the critically ill:use of exogenous marker compounds[J]. Crit Care, 2014, 18(6):657.
[24]
Barletta JF, Mangram AJ, Byrne M, et al. The importance of empiric antibiotic dosing in critically ill trauma patients[J]. J Trauma Acute Care Surg, 2016, 81(6):1115-1121.
[25]
Martin JH, Fay MF, Udy AA, et al. Pitfalls of using estimations of glomerular filtration rate in an intensive care population[J]. Intern Med J, 2011, 41(7):537-543.
[26]
Akers KS, Niece KL, Chung KK, et al. Modified Augmented Renal Clearance score predicts rapid piperacillin and tazobactam clearance in critically ill surgery and trauma patients[J]. J Trauma Acute Care Surg, 2014, 77(3 Suppl 2):S163-S170.
Minkutė R, Briedis V, Steponavičiūtė R, et al. Augmented renal clearance-an evolving risk factor to consider during the treatment with vancomycin[J]. J Clin Pharm Ther, 2013, 38(6):462-467.
[29]
Hirai K, Ishii H, Shimoshikiryo T, et al. Augmented renal clearance in patients with febrile neutropenia is associated with increased risk for subtherapeutic concentrations of vancomycin[J]. Ther Drug Monit, 2016, 38(6):706-710.
[30]
Nelson NR, Morbitzer KA, Dedrick JJ, et al. The impact of capping creatinine clearance on achieving therapeutic vancomycin concentrations in neurocritically ill patients with traumatic brain injury[J]. Neurocrit Care, 2019, 30(1):126-131.
[31]
Delattre IK, Taccone FS, Jacobs F, et al. Optimizing β-lactams treatment in critically-ill patients using pharmacokinetics/pharmacodynamics targets:are first conventional doses effective?[J]. Expert Rev Anti Infect Ther, 2017, 15(7):677-688.
[32]
Béranger A, Benaboud S, Urien S, et al. Piperacillin population pharmacokinetics and dosing regimen optimization in critically ill children with normal and augmented renal clearance[J]. Clin Pharmacokinet, 2018, 58(2):223-233.
[33]
Nichols K, Chung EK, Knoderer CA, et al. Population pharmacokinetics and pharmacodynamics of extendedinfusion piperacillin and tazobactam in critically ill children[J]. Antimicrob Agents Chemother, 2015, 60(1):522-531.
[34]
Cies JJ, Shankar V, Schlichting C, et al. Population pharmacokinetics of piperacillin/tazobactam in critically ill young children[J]. Pediatr Infect Dis J, 2013, 33(2):168-173.
[35]
Yu T, Stockmann C, Healy DP, et al. Determination of optimal amikacin dosing regimens for pediatric patients with burn wound sepsis[J]. J Burn Care Res, 2015, 36(4):e244-e252.
[36]
Dhont E, Van Der Heggen T, De Jaeger A, et al. Augmented renal clearance in pediatric intensive care:are we undertreating our sickest patients?[J]. Pediatr Nephrol, 2018. doi:10.1007/s00467-018-4120-2.[Epub ahead of print]
[37]
Cies JJ, Moore WS, Enache A, et al. β-lactam therapeutic drug management in the PICU[J]. Crit Care Med, 2017, 46(2):272-279.
