Prediction equation estimates of creatinine clearance in the intensive care unit.
OBJECTIVE
To assess the accuracy of 4 mathematical equations used to estimate creatinine clearance versus the 24-h creatinine clearance in ICU patients.


METHODS
Prospective study of renal function prediction.


METHODS
The general adult ICUs of 3 metropolitan hospitals.


METHODS
199 critically ill patients with indwelling foley catheters.


METHODS
Routine 24 h creatinine clearances were evaluated only in patients whose urine volume recorded by the nurses was within 10% of the laboratory's measured volume. Four mathematical equations utilizing age, sex, body weight, height, and plasma creatinine were used as a comparison. There was no difference in estimated creatinine clearance by 3 published methods when the 24 h creatinine clearance exceeded 100 ml/min. When the 24 h creatinine clearance was less than 100 ml/min, however, one prediction equation adjusted for lean body weight (LBW), was the most accurate. This equation accurately predicted creatinine clearance in the range of 30-100 ml/min and slightly overestimated creatinine clearance at 0-30 ml/min (p < 0.01, ANOVA all groups, p < 0.05 Fisher and Scheffé post-hoc tests) with a mean difference +/- 95% confidence interval of -5 +/- 3.1 ml/min.


CONCLUSIONS
An initial rapid estimate of creatinine clearance in critically ill ICU patients with reduced renal function can be determined by an equation adjusted for LBW.
Pesola
G R
GR
Department of Anesthesiology and Critical Care Medicine, Albert Einstein University at Montefiore Hospital, Bronx, NY.
Akhavan
I
I
Madu
A
A
Shah
N K
NK
Carlon
G C
GC
D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D016001:Confidence Intervals; D003404:Creatinine / Q000032:analysis*; D005260:Female; D006801:Humans; D007677:Kidney Function Tests / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012044:Regression Analysis; D012737:Sex Factors
D003404:Creatinine