Estimating Kidney Function in the Critically Ill Patients

Seller-Pérez, G.; Herrera-Gutiérrez, M.E.; Maynar-Moliner, Javier; Sánchez-Izquierdo-Riera, José A.; Marinho, A.; Pico, José Luis Do

doi:10.1155/2013/721810

Cited by 10 publications

(13 citation statements)

References 50 publications

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“…ICU patients also face a high risk of acute kidney injury, which also raises the risk of mortality. More than 30% of ICU patients suffer from kidney dysfunction of some degree [14]. In the present study, the creatinine level was stable and BUN levels increased gradually, supporting that the formula is safe and well tolerated by the kidneys.…”

Section: Discussionsupporting

confidence: 78%

Enteral tube feeding: Safety and tolerance of nutritional supplements in hospitalized patients

Kakkar¹,

Mehndiratta²,

Agrawal³

2020

Intergr Clin Med

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Objective: Most of the patients in intensive care unit (ICU) present nutritional challenges which needs to be compensated using enteral tube feeding (ETF). Maxvida™ is a commercially available balanced nutrition supplement with antioxidants, bone strengthening and hemoglobin forming nutrients. However, its benefits in patients have not yet been established. Therefore, the present study aimed to assess the efficacy and tolerability of Maxvida™ in ICU patients.Design: This was a two-week, prospective, open label, investigator-initiated study conducted between June-2016 to August-2016.Methods: Participants of either sex, aged ≥18 years, hospitalized for minimum two days, requiring enteral feeding were given two feeds of Maxvida™ (30 gm diluted in 100 mL of water) along with four standard kitchen feeds at different timings. Primary endpoint was to monitor continuous GI tolerance. Secondary endpoints were change in leukocyte count, nutrient, renal, hepatic and hematological parameters. Data was analyzed descriptively using paired t-test and p value of <0.05 was considered statistically significant.Results: Fifteen (11 males, 4 females, mean age: 46.3 ± 8.9 years) participants were enrolled. None of them reported gastric intolerance. A significant improvement in hemoglobin (p=0.03), hematocrit (p=0.003), white blood cells (p=0.0001*) levels was reported while RBC, platelet, differential leukocyte count also improved gradually. Conclusion:Maxvida™ administered with hospital kitchen feed were found to be safe and gastro-intestinally well tolerated by all the participants.

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Section: Discussionsupporting

confidence: 78%

Enteral tube feeding: Safety and tolerance of nutritional supplements in hospitalized patients

Kakkar¹,

Mehndiratta²,

Agrawal³

2020

Intergr Clin Med

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“…In clinical practice, serum creatine (sCr) and cystatine C (CysC) were common biomarkers used to evaluate the glomerular filtration function. However, their performance in critically ill patients was not universally agreed [10][11][12][13][14][15]. Some studies [10,[16][17][18] considered sCr highly misleading in ICU patients because of muscle mass loss and volume overload in many critically ill patients.…”

Section: Introductionmentioning

confidence: 99%

Divergence between serum creatine and cystatin C in estimating glomerular filtration rate of critically ill COVID-19 patients

et al. 2021

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Background: The clinical use of serum creatine (sCr) and cystatin C (CysC) in kidney function evaluation of critically ill patients has been in continuous discussion. The difference between estimated glomerular filtration rate calculated by sCr (eGFRcr) and CysC (eGFRcysc) of critically ill COVID-19 patients were investigated in this study. Methods: This is a retrospective, single-center study of critically ill patients with COVID-19 admitted in intensive care unit (ICU) at Wuhan, China. Control cases were moderate COVID-19 patients matched in age and sex at a ratio of 1:1. The eGFRcr and eGFRcysc were compared. The association between eGFR and death were analyzed in critically ill cases. The potential factors influencing the divergence between eGFRcr and eGFRcysc were explored. Results: A total of 76 critically ill COVID-19 patients were concluded. The mean age was 64.5 ± 9.3 years. The eGFRcr (85.45 (IQR 60.58-99.23) ml/min/1.73m 2 ) were much higher than eGFRcysc (60.6 (IQR 34.75-79.06) ml/min/1.73m 2 ) at ICU admission. About 50 % of them showed eGFRcysc < 60 ml/min/1.73 m 2 while 25% showed eGFRcr < 60 ml/min/1.73 m 2 (v 2 ¼ 10.133, p ¼ 0.001). This divergence was not observed in moderate group. The potential factors influencing the divergence included serum interleukin-6 (IL-6), tumor necrosis factor (TNF-a) level as well as APACHEII, SOFA scores. Reduced eGFRcr (<60 mL/min/1.73 m 2 ) was associated with death (HR ¼ 1.939, 95%CI 1.078-3.489, p ¼ 0.027). Conclusions: The eGFRcr was generally higher than eGFRcysc in critically ill COVID-19 cases with severe inflammatory state. The divergence might be affected by inflammatory condition and illness severity. Reduced eGFRcr predicted in-hospital death. In these patients, we advocate for caution when using eGFRcysc.

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“…Некоторые исследователи [21,22], ссы-лаясь на статью M. Moran и соавт. [23] либо утверждая самолично [14], предполагают, что концентрация креати-нина в плазме крови может увеличиваться только через 24-48 ч после снижения СКФ, отставая от истинной скорости клубочковой фильтрации.…”

Section: маркеры для измерения скфunclassified

Choosing the Optimal Method for Measuring Glomerular Filtration Rate in Pediatric Intensive Unit

et al. 2018

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The measurement of glomerular filtration rate (GFR) ВВЕДЕНИЕСкорость клубочковой фильтрации (СКФ) -это объем плазмы крови, прошедший через почечный клу-бочек за единицу времени и очищенный от конкретного вещества [1]. Ее вычисление остается существенно важным для оценки функции почек у детей и взрослых [2]. Определение СКФ является «золотым стандартом» диагностики острого и хронического почечного повреж-дения [3,4]. Снижение СКФ требует коррекции режима дозирования большинства препаратов, используемых в отделении интенсивной терапии [5]. Однако измере-ние СКФ часто проводится с ошибками [6], так как не все методы или формулы с достаточной точностью вос-производят необходимые измерения и вычисления [7,8]. Поэтому важно определить наиболее достоверные методы оценки и область применения той или иной формулы расчета СКФ, исключая их неправильное при-ложение. МАРКЕРЫ ДЛЯ ИЗМЕРЕНИЯ СКФВсе маркеры для измерения СКФ можно подразде-лить на две основные группы -эндогенные и экзоген-ные. К экзогенным маркерам относятся инулин, йогексол, йоталамат и некоторые радионуклиды хрома и технеция, к эндогенным -креатинин и цистатин С. Считается, что идеальным маркером СКФ является тот, который фильтруется через клубочек на 100%, не реабсорби-руется и не секретируется в проксимальных или дис-тальных отделах нефрона [2]. Лабораторным «золотым стандартом» экзогенного маркера для оценки СКФ на сегодняшний день является инулин, так как он целиком соответствует вышеуказанным требованиям [2]. Однако в клинической практике инулин не применим, использу-ется только в экспериментальных моделях ввиду своей дороговизны и отсутствия стандартизированного мето-да измерения его концентрации в моче и плазме [1]. Иные экзогенные маркеры также обладают высокой

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Estimating Kidney Function in the Critically Ill Patients

Cited by 10 publications

References 50 publications

Enteral tube feeding: Safety and tolerance of nutritional supplements in hospitalized patients

Enteral tube feeding: Safety and tolerance of nutritional supplements in hospitalized patients

Divergence between serum creatine and cystatin C in estimating glomerular filtration rate of critically ill COVID-19 patients

Choosing the Optimal Method for Measuring Glomerular Filtration Rate in Pediatric Intensive Unit

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