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Objective of the work: The purpose of this quantitative retrospective comparative study was to register possible cases of augmentedted renal clearance (ARC) in patients of Hospital of Lithuanian University of Health Sciences and analyse the differences in assessments of cases of Augmented Renal Clearance and the drug therapy problems related to ARC. Tasks: To achieve the objective, several tasks were performed: 1) to register possible ARC patients cases as assessed by Cocroft-Gault and their possible associated reasons; 2) to analyse differences in three equations used for GFR estimation: Cocroft-Gault, MDRD simplified, and CKD-EPI. 3) compare the therapies of the patients and determine the drugs that are in risk of being underdosed when ARC is present. Methodology: An ARC survey (appendix 1) was filled about patients from various departments of Clinics during the period of 2013 03 04 – 2014 08 15. All patients were selected according serum creatinine values that were 50 µmol/l. or less. Two goups of patients were assigned for analysis: patients were grouped according Cocroft - Gault creatinine clearance values: (1) ARC group A CrCl >130 ml./min and (2) comparative Non-ARC group B CrCl 90-130 ml./min. Data were analyzed by using descriptive and comparative statistical analysis, considering statistically significant difference between the groups if p value was <0.05. Results and conclusions: 1. In the research group and comparative groups were 31 patients selected... [to full text] / Darbo tikslas: Šio kiekybinio retrospektyvaus palyginamojo darbo tikslas buvo surinkti duomenis apie padidinto inkstų klirenso PIK atvejus Lietuvos sveikatos mokslų universiteto ligonines Kauno klinikose. Buvo siekiama išanalizuoti sirtumus tarp skirtingų PIK įvertinimo būdų ir įvertinti galimas su PIK susijusias terapijos problemas. Uždaviniai: norint pasiekti užsibrėžtus tikslus šie uždaviniai buvo iškelti: 1) užregistruoti PIK atvejus ir nustatyti jų galimas priežastis. 2) apskaičiuoti GFG trimis skirtingomis formulėmis (Cocroft-Gault, MDRD, CKD-EPI) ir išanalizuoti skirtumus. 3) palyginti pacientų terapijas ir nustatyti, kurie vaistai galimai yra subterapinio dozavimo rizikoje Metodika: PIK anketa ( 1 priedas) buvo pildoma apie pacientus iš skirtingų Kauno klinikų skyrių, laikotarpiu nuo 2013 03 04 iki 2014 08 15. Visi pacientai buvo parinkti pagal kreatinino kiekį serume – 50 μmol/l.. ir mažiau. Dvi pacientų grupės buvo parinktos analizei: pacientai buvo sugrupuoti pagal kreatinino klirensą į (1) PIK A grupę – CrCl > 130 ml./min. ir (2) palyginamąją B grupę – CrCl 90-130 ml./min. Duomenys buvo analizuojami naudojant palyginamąją ir aprašomąją statistiką. Skirtumai tarp grupių buvo laikomi statistiškai reikšmingi, kai p reikšmė buvo <0.05. Rezultatai ir išvados: 1. Abiejose grupėse buvo surinkta po 31 pacientą (iš viso 62 pacientai). Remiantis darbo rezultatais, galima daryti išvadą, kad PIK (kai GFG yra 130ml/min. ir daugiau) nustatymui naudojant Cocroft-Gault formulę... [toliau žr. visą tekstą]

In recent years, the focus on augmented renal clearance increased as it was found by other researchers to result in subtherapeutic drug dosing concentrations. Accurate assessment of renal function is important for prescribing optimal dosis of pharmaceuticals for ARC patients. Objective of the work: The purpose of this quantitative retrospective comparative study was to register possible cases of Accelerated renal clearance in patients of Hospital of Lithuanian University of Health Sciences Kaunas Clinics and analyse the differences in assessments of cases of Augmented Renal Clearance and the possible risks of ARC for therapy. Tasks: To achieve the objective several tasks were raised: 1) to register possible ARC patients cases as assessed by Cocroft-Gault and their possible associated reasons; 2) to analyse differences in three for GFR estimation used equations (Cocroft-Gault, MDRD simplified, and CKD-EPI). 3) determine the risk drugs for changed renal elimination. Methodology: ARC survey (appendix 1) was filled about patients from various departments of Clinics during the period of 2013 03-04 – 2013 12-20. All patients were selected according serum creatinine values that were 50 µmol/l. or less. Two goups of patients were assigned for analysis: patients were grouped according Cocroft - Gault creatinine clearance values: (1) ARC group A CrCl >130 ml./min and (2) comparative Non-ARC group B CrCl 90-130 ml./min. In the group A were 31 and in the group B - 5 patients... [to full text] / Pastaraisiais metais labai išaugo tyrimų apie padidintą inkstų klirensą (PIK), nes pagal keleto tyrejų duomenis šios būklės pasekmė yra subterapinės vaistų koncentracijos. Tikslus inkstų funkcijos nustatymas yra labai svarbus norint parinkti optimalias terapines vaistų dozes padidinto inkstų klirenso pacientams. Darbo tikslas: Šio kiekybinio retrospektyvaus palyginamojo darbo tikslas buvo surinkti duomenis apie padidinto inkstų klirenso PIK atvejus Lietuvos sveikatos mokslų universiteto ligonines Kauno klinikose. Buvo siekiama išanalizuoti sirtumus tarp skirtingų PIK įvertinimo būdų ir įvertinti galimas PIK rizikas terapijai Uždaviniai: norint pasiekti užsibrėžtus tikslus šie uždaviniai buvo iškelti: 1) užregistruoti PIK atvejus ir nustatyti jų galimas priežastis. 2) apskaičiuoti GFG trimis skirtingomis formulėmis (Cocroft-Gault, MDRD, CKD-EPI) ir išanalizuoti skirtumus. 3) nustatyti vaistus, kurie gali būti pakitusios inksų eliminacijos rizikoje. Metodika: PIK anketa ( 1 priedas) buvo pildoma apie pacientus iš skirtingų Kauno klinikų skyrių, laikotarpiu nuo 2013 04 03 iki 2013 12 20. Visi pacientai buvo parinkti pagal kreatinino kiekį serume – 50 µmol/l.. ir mažiau. Dvi pacientų grupės buvo parinktos analizei: pacientai buvo sugrupuoti pagal kreatinino klirensą į (1) PIK A grupę – CrCl > 130 ml./min. ir (2) palyginamąją B grupę – CrCl 90-130 ml./min. A grupėje buvo parinktas 31 pacientas ir B grupėje 5 pacientai. Rezultatai: Vidutinės GFG reikšmės tiriamojoje... [toliau žr. visą tekstą]

>Magister Scientiae - MSc / The aim of this study was to compare the trough plasma levels of Aspen-Vancomycin® (AV); and Sandoz-Vancocin CP® (SV) in premature infants with suspected Methicillin Resistant Staphylococcus aureus (MRSA) infection. The study was designed as a prospective, double blind, randomised trial involving male and female premature infants admitted in the Neonatal Intensive care Unit (NICU) at Netcare Blaauwberg and N1-city Hospitals for treatment of suspected MRSA-infection between April 2012 and June 2013. The inclusion criteria were: 29-35 weeks postmenstrual age (PMA), informed and written consent from parents of each premature infant enrolled in the study. Blood samples (0.3-0.4ml) were collected for renal function test and vancomycin trough levels determination. Blood samples for vancomycin trough level assay were collected thirty minutes prior to the administration of the third dose of vancomycin. Statistical analysis was performed and estimation was made giving an indication of how many infants will be needed to make the study statistically significant. Wilcoxon Two-Sample test was performed to determine the p-values and Spearman correlation coefficients were used to determine the correlation between trough levels and variables. P-values < 0.05 were considered significant. A total of 19 premature infants met with study criteria, 10 (5 females and 5 males) received AV and 9 (6 females and 3 males) receive d SV. There was no statistical significant difference between the demographic (GA, BW, PMA, PNA, weight at trial entry, height at trial entry) and biological (albumin, serum creatinine concentration and glomerular filtration rate) parameters of the premature infants in the AV and SV group. There were no statistical significant difference between trough level 1 of AV and SV, although trough level 1 had a lower trend in the SV group (p=0.118). No AV trough level 1 was below the minimum effective concentration (<5μg/ml). It was found that 30% of AV trough level 1 was within the therapeutic range (5-10μg/ml) and 70% of AV trough level 1, were above minimum toxic concentration (>10mg/l). It was found that 22.2% of SV trough level 1 was below minimum effective concentration, 44.4% of SV trough level 1 was within therapeutic range and 33.3% of trough level 1 was above minimum toxic concentration. No correlation was found between trough level 1 and the demographic and biological parameters of the premature infants in the AV group. SV had a positive correlation with GA, BBW, PMA and a negative correlation with PNA