Augmented renal clearance was present in 83.3% of acute stroke patients, with independent predictors including hemorrhagic stroke, male sex, younger age, and lower admission serum creatinine.
Observational (n=174)
Yes
Augmented renal clearance is highly prevalent (83.3%) among acute stroke patients in the Neuro-ICU, highlighting a risk for subtherapeutic drug levels.
Abstract Background and aims Patients with acute stroke Ishcemic stroke (IS), intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH) are at risk for augmented renal clearance (ARC), a hyperfiltration state (creatinine clearance (CLCR) 130 mL/min/1.73m2) that can cause therapeutic failure due to subtherapeutic drug levels. Because standard laboratory markers often fail to identify ARC, clinical recognition is vital to avoid complications. We aimed to characterize the prevalence and independent predictors of ARC in this population. Methods This was a multicenter, prospective observational study recruiting patients with acute neurological illnesses admitted to participating Neuro-ICUs. CLCR was measured using 8-hour urine collection for up to 10 days. Patients were dichotomized into ARC and no-ARC groups. Patient demographics and clinical scores were collected and compared. Data are presented as mean±SD, median(IQR), or n(%), as appropriate. Results To date, 174 patients have been recruited (71(40.8%) SAH, 56(32.2%) ICH, and 47(27.0%) IS). The overall prevalence of ARC was 145(83.3%, mean CLCR 146.33 ± 49.6 mL/min/1.73m2). Prevalence by diagnosis was 31(66.0%) for IS, 49(87.5%) for ICH, and 65(91.5%) for SAH. ARC patients were younger (56.55 ± 12.72 vs 61.58 ± 14.24 years, p-value=0.05) with trends toward lower admission serum creatinine (67(25.4) vs 75(28) μmol/L, p-value=0.0941) and more male trends (78(53.8%) vs 13(44.8%), p-value=0.378). Multivariate analysis identified diagnosis (particulary those with hemorrhagic stroke), male sex, younger age, and lower admission serum creatinine as independent predictors of ARC. Conflict of interest Maged Kharouba: nothing to disclose
Kharouba et al. (Fri,) conducted a observational in Acute stroke (n=174). Augmented renal clearance vs. No augmented renal clearance was evaluated on Prevalence of augmented renal clearance. Augmented renal clearance was present in 83.3% of acute stroke patients, with independent predictors including hemorrhagic stroke, male sex, younger age, and lower admission serum creatinine.