title: Use of 2-hour creatinine clearance to guide cessation of continuous renal replacement therapy.
abstract: OBJECTIVE
  A simple test that could guide successful cessation of continuous renal replacement therapy (CRRT) in critically ill patients would be clinically useful. This study aimed to investigate whether a 2-hour creatinine clearance (2h-CrCl) measurement could more accurately predict successful cessation of CRRT than serum creatinine or urine output alone.
  
  
  METHODS
  This retrospective study identified all patients admitted to a university teaching hospital intensive care unit who received CRRT and had a 2h-CrCl measurement performed in the 12 hours preceding CRRT cessation. The ability of 2h-CrCl to predict successful discontinuation of CRRT was compared to other renal indices.
  
  
  RESULTS
  Of 85 patients who had 2h-CrCl performed prior to CRRT cessation 53 (62.4%)(success group) remained dialysis free 7 days after CRRT cessation. 2h-CrCl was a better predictor of remaining CRRT free at day 7 (OR, 1.108 [1.05-1.17] per 1 mL/min increase in 2 hours CrCl, P < .001) than urine output, serum creatinine or age. A 2h-CrCl value of 23 mL/min had a sensitivity, specificity and positive predictive value for remaining CRRT free at day 7 of 75.5%, 84.4%, and 88.8%, respectively.
  
  
  CONCLUSIONS
  2h-CrCl may be a useful measurement to help guide discontinuation from CRRT.
authors.affiliation: National SpR Academic Fellowship Programme, St Vincent's University Hospital, Dublin 4, Ireland. frohlics@yahoo.co.uk
authors.forename: Stephen
authors.initials: S
authors.lastname: Fröhlich
authors.forename: Amy
authors.initials: A
authors.lastname: Donnelly
authors.forename: Orsolya
authors.initials: O
authors.lastname: Solymos
authors.forename: Niamh
authors.initials: N
authors.lastname: Conlon
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003404:Creatinine / Q000378:metabolism*; D016638:Critical Illness; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D017582:Renal Replacement Therapy / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D003404:Creatinine