Evaluation of Kidney Function in Patients With Acute Renal Failu
Evaluation of Kidney Function in Patients With Acute Renal Failu
Accurate measurement of glomerular function rate (GFR) in the setting of acute renal failure is difficult to achieve with current clinical methods, such as measuring plasma creatinine concentration and 24-hour urine creatinine clearance. High-performance liquid chromatography was used to measure GFR directly in a critically ill patient with acute renal failure. This approach involved evaluating the elimination kinetics of nonionic contrast material administered intravenously for radiologic imaging. It required no additional patient exposure to radiographic contrast media and enabled caregivers to determine kidney function accurately in the presence of worsening clinical status and delayed changes in plasma creatinine. This and other methods for more accurate measurement of GFR in patients with acute renal failure may provide the foundation for clinical studies that assess the severity and management of acute renal failure.
Between 3 and 16% of critically ill patients develop acute renal failure, a condition associated with high mortality in this patient population. The diagnosis and management of acute renal failure are compromised by the lack of an accurate method for measuring glomerular filtration rate (GFR). We used high-performance liquid chromatography (HPLC) to measure radiographic contrast material administered for imaging purposes in a critically ill patient with acute renal failure. We then used standard pharmacokinetic equations to determine GFR. This approach allowed accurate quantification of the severity of renal dysfunction and facilitated rational drug dosing despite minimally changing serum creatinine concentrations. This and related methods may provide the foundation for studies that attempt to measure GFR accurately in patients with acute renal failure.
Accurate measurement of glomerular function rate (GFR) in the setting of acute renal failure is difficult to achieve with current clinical methods, such as measuring plasma creatinine concentration and 24-hour urine creatinine clearance. High-performance liquid chromatography was used to measure GFR directly in a critically ill patient with acute renal failure. This approach involved evaluating the elimination kinetics of nonionic contrast material administered intravenously for radiologic imaging. It required no additional patient exposure to radiographic contrast media and enabled caregivers to determine kidney function accurately in the presence of worsening clinical status and delayed changes in plasma creatinine. This and other methods for more accurate measurement of GFR in patients with acute renal failure may provide the foundation for clinical studies that assess the severity and management of acute renal failure.
Between 3 and 16% of critically ill patients develop acute renal failure, a condition associated with high mortality in this patient population. The diagnosis and management of acute renal failure are compromised by the lack of an accurate method for measuring glomerular filtration rate (GFR). We used high-performance liquid chromatography (HPLC) to measure radiographic contrast material administered for imaging purposes in a critically ill patient with acute renal failure. We then used standard pharmacokinetic equations to determine GFR. This approach allowed accurate quantification of the severity of renal dysfunction and facilitated rational drug dosing despite minimally changing serum creatinine concentrations. This and related methods may provide the foundation for studies that attempt to measure GFR accurately in patients with acute renal failure.