Incidence and determinats of augmented renal clearance in traumatic brain injury: A prospective observational study

Abstract

Purpose: To characterize the incidence, timing, and predictors of augmented renal clearance (ARC) in patients with traumatic brain injury (TBI).

Materials and methods: In 61 patients with TBI, creatinine clearance (CrCl) was prospectively measured from urine samples, over seven days. ARC was defined as a CrCl >130 mL/min/1.73 m² in at least one day. We compared patients with and without ARC.

Results: We performed 295 determinations of CrCl. ARC was present in 82% of the patients and arose in the first 2 days in 86% of them. ARC was more frequent in patients with associated injuries (100 vs. 75%, P = 0.02). There was a trend to a more aggressive resuscitation in patients with ARC but young age was the only independent predictor. Hospital length of stay was higher in ARC (15 [8-25] vs. 6 [3-19] days, P < 0.05).

Conclusions: ARC is very common and has an early appearance in patients with TBI. Young age is its main determinant.

Keywords: Age; Augmented renal clearance; Creatinine; Traumatic brain injury.