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Replacement of 24-h creatinine clearance by 2-h creatinine clearance in intensive care unit patients: a single-center study

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To estimate the usefulness of 2-h creatinine clearance (CrCl) in the ICU and define variables that may reduce agreement.


Prospective study.


Polyvalent ICU of a university hospital.


359 patients.


We compared 24-h CrCl (CrCl-24h), as the standard measure, with 2-h CrCl (CrCl-2h) (at the start of the period) and the Cockroft–Gault equation (Ck-G).

Measurements and results

The 2-h sample was lost in two patients (0.6%) and the 24-h sample was lost in 50 patients (13.9%). The mean Ck-G was 87.4 ± 3.05, with CrCl-2h 109.2 ± 4.46 and CrCl-24h 100.9 ± 4.21 ml/min/1.73 m2 (r 2 of 0.88 for CrCl-2h and 0.84 for Ck-G). The differences from ClCr-24h were 21.8 ± 3.3 ( p < 0.001) for the Ck-G and 8.3 ± 2.6 ( p < 0.05) for CrCl-2h ( p < 0.05). In the subgroup of patients with CrCl-24h < 100 ml/min/1.73 m2, the CrCl-24h value was 52.9 ± 2.71 vs. 51.6 ± 2.14 for CrCl-2h ( p = ns) and 57.6 ± 2.56 ( p < 0.001) for the Ck-G. Patients with CrCl < 100 ml/min only showed variability in hyperglycemia during the 24-h period.


In intensive care patients, 24-h CrCl results in a large proportion of non-valid determinations, even under conditions of close monitoring. Two-hour CrCl is an adequate substitute, even in patients who are unstable or who have irregular diuresis where a 24-h collection is impossible. The Cockroft–Gault equation seems less useful in this setting.

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Correspondence to Manuel E. Herrera-Gutiérrez.

Additional information

All the authors participated actively in the present study. This is an original paper that has not been submitted for publication elsewhere, though partial results of the study were presented at the Annual Congress of the ESICM in Amsterdam (September 2005), and the final results were presented at the Annual Congress of the SEMICYUC (Pamplona, 2006).

The authors received no external financing for conduct of the study, and there are no conflicts of interest for any of them.

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Herrera-Gutiérrez, M.E., Seller-Pérez, G., Banderas-Bravo, E. et al. Replacement of 24-h creatinine clearance by 2-h creatinine clearance in intensive care unit patients: a single-center study. Intensive Care Med 33, 1900–1906 (2007).

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