title: Increased creatinine clearance in polytrauma patients with normal serum creatinine: a retrospective observational study.
abstract: BACKGROUND
  The aim of this study, performed in an intensive care unit (ICU) population with a normal serum creatinine, was to estimate urinary creatinine clearance (CLCR) in a population of polytrauma patients (PT) through a comparison with a population of non trauma patients (NPT).
  
  
  METHODS
  This was a retrospective, observational study in a medical and surgical ICU in a university hospital. A total of 284 patients were consecutively included. Two different groups were studied: PT (n = 144) and NPT (n = 140). Within the second week after admission to the ICU, renal function was assessed using serum creatinine, 24 h urinary CLCR .
  
  
  RESULTS
  Among the 106 patients with a CLCR above 120 mL minute(-1) 1.73 m(-2), 79 were PT and 27 NPT (P < 0.0001). Only 63 patients had a CLCR below 60 mL minute(-1) 1.73 m(-2) with 15 PT and 48 NPT (P < 0.0001). Patients with CLCR greater than 120 mL minute(-1). 1.73 m(-2) were younger, had a lower SAPS II score and a higher male ratio as compared to those having CLCR lower than 120 mL minute(-1). 1.73 m(-2). Through a logistic regression analysis, age and trauma were the only factors independently correlated to CLCR.
  
  
  CONCLUSIONS
  In ICU patients with normal serum creatinine, CLCR, is higher in PT than in NPT. The measure of CLCR should be proposed as routine for PT patients in order to adjust dose regimen, especially for drugs with renal elimination.
authors.affiliation: Department of Anesthesiology and Intensive Care, GRCB 48, IFR 150, Toulouse University Hospital, Toulouse, France. minville.v@chu-toulouse.fr
authors.forename: Vincent
authors.initials: V
authors.lastname: Minville
authors.forename: Karim
authors.initials: K
authors.lastname: Asehnoune
authors.forename: Stephanie
authors.initials: S
authors.lastname: Ruiz
authors.forename: Audrey
authors.initials: A
authors.lastname: Breden
authors.forename: Bernard
authors.initials: B
authors.lastname: Georges
authors.forename: Thierry
authors.initials: T
authors.lastname: Seguin
authors.forename: Ivan
authors.initials: I
authors.lastname: Tack
authors.forename: Acil
authors.initials: A
authors.lastname: Jaafar
authors.forename: Sylvie
authors.initials: S
authors.lastname: Saivin
authors.forename: Olivier
authors.initials: O
authors.lastname: Fourcade
authors.forename: Kamran
authors.initials: K
authors.lastname: Samii
authors.forename: Jean Marie
authors.initials: JM
authors.lastname: Conil
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood / Q000652:urine; D016022:Case-Control Studies; D003404:Creatinine / Q000097:blood / Q000652:urine*; D003422:Critical Care / Q000379:methods*; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014947:Wounds and Injuries / Q000097:blood / Q000503:physiopathology* / Q000652:urine
chemical_list: D015415:Biomarkers; D003404:Creatinine