Augmented renal clearance in neurocritical care patients: A retrospective cohort study

Abstract

Background: Augmented renal clearance (ARC) in critical patients is concerning because it is associated with subtherapeutic antimicrobial or antiepileptic drug concentrations, increased length of stay, and possibly higher mortality. This study aimed to describe the characteristics between ARTIC score and estimated glomerular filtration rate (eGFR) in the neurocritical care population. Methods: A retrospective cohort study was conducted in the neurocritical care unit. Patients admitted to the neurocritical care unit between 2016 and 2018 with a stay longer than 48 h were retrospectively analyzed regarding the incidence, risk factors, and outcomes of ARC. Results: An ARTIC score of 6 or higher was present in 54.2% of patients, and 5.0% met the criteria for ARC due to eGFRCKD-EPI. The incidence of AKI was 23.5%. Polyuria was observed in 50.0% of patients, and hyponatremia and hypernatremia were observed in 16.9% and 40.9% of patients, respectively. Conclusion: ARC is a common phenomenon in the neurocritical care unit, especially in younger patients without cardiovascular comorbidities, and was associated with less acute kidney injury and less mortality.