Skip to main content
Log in

Critical care

Estimating renal function in the ICU: even more challenging

  • News & Views
  • Published:

From Nature Reviews Nephrology

View current issue Sign up to alerts

Estimating renal function in the normal to high range is challenging, and even more so in critically ill patients. An analysis of commonly used equations for estimating renal function demonstrates that these formulae might not be accurate in this setting, which has important implications for drug dosing.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  1. Poggio, E. D. et al. Performance of the Cockcroft-Gault and Modification of Diet in Renal Disease equations in estimating GFR in ill hospitalized patients. Am. J. Kidney Dis. 46, 242–252 (2005).

    Article  PubMed  Google Scholar 

  2. U. S. Department of Health and Human Services. Guidance for industry: pharmacokinetics in patients with impaired renal function—study design, data analysis, and impact on dosing and labeling [online], (1998).

  3. Cockcroft, D. W. et al. Prediction of creatinine clearance from serum creatinine. Nephron 16, 31–41 (1976).

    Article  CAS  PubMed  Google Scholar 

  4. Levey, A. S. et al. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann. Intern. Med. 130, 461–470 (1999).

    Article  CAS  PubMed  Google Scholar 

  5. Levey, A. S. et al. A new equation to estimate glomerular filtration rate. Ann. Intern. Med. 150, 604–612 (2009).

    Article  PubMed  PubMed Central  Google Scholar 

  6. Baptista, J. et al. A comparison of estimates of glomerular filtration in critically ill patients with augmented renal clearance. Crit. Care 15, R139 (2011).

    Article  PubMed  PubMed Central  Google Scholar 

  7. Lipman, J., Wallis, S. C. & Boots, R. J. Cefepime versus cefpirome: the importance of creatinine clearance. Anesth. Analg. 97, 1149–1154 (2003).

    Article  CAS  PubMed  Google Scholar 

  8. Udy, A. et al. Augmented creatinine clearance in traumatic brain injury. Anesth. Analg. 111, 1505–1510 (2010).

    Article  CAS  PubMed  Google Scholar 

  9. Georges, B. et al. Population pharmacokinetics of ceftazidime in intensive care unit patients: influence of glomerular filtration rate, mechanical ventilation, and reason for admission. Antimicrob. Agents Chemother. 53, 4483–4489 (2009).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Poggio, E. D. et al. Performance of the Modification of Diet in Renal Disease and Cockcroft-Gault equations in the estimation of GFR in health and in chronic kidney disease. J. Am. Soc. Nephrol. 16, 459–466 (2005).

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Emilio D. Poggio.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Demirjian, S., Poggio, E. Estimating renal function in the ICU: even more challenging. Nat Rev Nephrol 7, 549–550 (2011). https://doi.org/10.1038/nrneph.2011.126

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrneph.2011.126

  • Springer Nature Limited

Navigation