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Observational Study
. 2023 Feb;38(1):35-40.
doi: 10.1007/s12028-022-01569-1. Epub 2022 Aug 3.

Augmented Renal Clearance in Patients with Acute Ischemic Stroke: A Prospective Observational Study

Grace John  1 , Erika Heffner  2 , Tracy Carter  2 , Regan Beckham  3 , Nathan Smith  3
Affiliations
Observational Study

Augmented Renal Clearance in Patients with Acute Ischemic Stroke: A Prospective Observational Study

Grace John et al. Neurocrit Care. 2023 Feb.

Abstract

Background: Augmented renal clearance (ARC) is a phenomenon that has been demonstrated in many subsets of critically ill patients and is characterized by a creatinine clearance (CrCl) > 130 mL/min. Prior research has examined ARC prevalence in the presence of sepsis, traumatic brain injury, subarachnoid hemorrhage, and intracranial hemorrhage. However, to our knowledge, no studies have examined whether this phenomenon occurs in patients suffering from an acute ischemic stroke (AIS). The objective of this study was to evaluate whether patients experiencing an AIS exhibit ARC, identify potential contributing factors, and examine the precision of current renal clearance estimation methods in patients with AIS experiencing ARC.

Methods: This was a single-center prospective observational study conducted in adult patients admitted to a neurocritical intensive care unit (ICU) at a community hospital. Once consent was gained, patients with an admitting diagnosis of an AIS underwent a 24-h urine collection to assess measured CrCl. The primary end point assessed for ARC, defined as a measured CrCl > 130 mL/min. The secondary end point evaluated length of stay in the neurocritical ICU.

Results: Twenty-eight patients met enrollment criteria, and data was analyzed for 20 patients. ARC was present in 35% of enrolled patients. Mathematical estimations of renal function were inadequate in detecting ARC manifestation. Patients experiencing ARC were associated with nonsignificantly shorter ICU length of stay.

Conclusions: ARC appears to manifest in patients with AIS inconsistently. Patients experiencing ARC were associated with nonsignificantly shorter ICU length of stay.

Keywords: Augmented renal clearance; Creatinine clearance; Enhanced renal clearance; Ischemic stroke.

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Conflict of interest statement

The authors have nothing to disclose.

Figures

Fig. 1
Fig. 1
Flowchart of enrolled patients in the study
Fig. 2
Fig. 2
Boxplot of intensive care unit (ICU) length of stay for patients with augmented renal clearance (ARC) and without ARC. Means are marked with “X.” The test for difference in means was not significant (p = 0.06)
See this image and copyright information in PMC

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