Background Patients in the intensive care unit often receive broad spectrum antibiotic (e.g., gentamicin) treatment that are mostly eliminated through the renal route. Therefore, the kidney function is a crucial factor to establish a good dosage regimen especially in patients with acute kidney injuries. Old-fashioned estimation formulas are used today to estimate the kidney function and there is room for improvement. A publication from 2009 have presented that clearance for gentamicin is a good enough estimation compared to the golden standard measurement methods. Aim The aim of the study was to first find and investigate already developed equations to estimate non-steady-state kidney function. Thereafter, the aim was to identify which equations, both suited for steady-state and non-steady-state situations, that could best correlate to CLg in adult ICU patients. Methods PubMed was used to gather data about non-steady-state kidney function. The equations were then applied on Excel and a dataset containing 100 patients was used to calculate kidney function estimates. Clearance for gentamicin were then compared to the estimates using linear regression, Bland-Altman plots and P30 values. Results and discussion The Cockcroft-Gault formula had the highest P30-value, while Grubb’s cystatin C formula generated the best Bland-Altman plot as well as the best linear regression. However, neither of these were good enough to be used in the clinical work. Surprisingly, the Jelliffe equation was the poorest to estimate kidney function. Conclusion None of the evaluated estimations were clinically good enough to replace the gentamicin clearance method.
| Identifer | oai:union.ndltd.org:UPSALLA1/oai:DiVA.org:uu-507330 |
| Date | January 2023 |
| Creators | Goriya, Yousef |
| Publisher | Uppsala universitet, Institutionen för farmaci, Uppsala university |
| Source Sets | DiVA Archive at Upsalla University |
| Language | English |
| Detected Language | English |
| Type | Student thesis, info:eu-repo/semantics/bachelorThesis, text |
| Format | application/pdf |
| Rights | info:eu-repo/semantics/openAccess |
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