Evidence map›Paper›PMID 21769107›Full record

ReviewNature reviews. Nephrology2011

Implications of augmented renal clearance in critically ill patients.

Andrew A Udy, Jason A Roberts, Jeffrey Lipman

Registry-linked trialAbstract readReview
PubMed Publisher
In one paragraph

Review in Nature reviews. Nephrology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06293677 (Upwards Initial Adjustment of Wide-Spectrum Antibiotic Dosage in Pediatric Oncology Patients With Febrile Neutropenia and Suspected Augmented Renal Clearance), which is not on this map. Cited by 84 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
84citing papers in PubMed, 1 pooled it
12.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06293677 phase4unknown statusnot on this mapstarted 2024, after this paper: background citation

Upwards Initial Adjustment of Wide-Spectrum Antibiotic Dosage in Pediatric Oncology Patients With Febrile Neutropenia and Suspected Augmented Renal Clearance: A Randomized Controlled Trial With Therapeutic Drug Monitoring

TypeinterventionalSponsorCentre Hospitalier Universitaire VaudoisRan2024 to 2026Enrolled30ConditionsFebrile NeutropeniaArmsDosage Adjustment Rules for Augmented Renal Clearance (DAR-ARC) for piperacillin-tazobactam and meropenem, Standard dosages of piperacillin-tazobactam or meropenem
3 · Its place in the literature

Who cites it

84 citing papers in PubMed, 1 synthesis or guideline pooled it, 208 citations in OpenAlex.

  1. Pooled it
  2. Trial
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  6. Review
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  10. Optimization of cefepime dosage regimens forGlobal health & medicine · 2025
    Article
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  14. Observational
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  16. Central-venous-catheter-related bloodstream infections in adult patients with sickle cell disease: a retrospective, two-centre study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025
    Observational
  17. Review
  18. Article
  19. Review
  20. Article

24 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 1 country.

Andrew A UdyBurns, Trauma, and Critical Care Research Center, University of Queensland, Royal Brisbane and Women's Hospital, Herston, QLD 4029, Australia. andrew_udy@health.qld.gov.au
Jason A Roberts
Jeffrey Lipman
Royal Brisbane and Women's Hospital · AUUniversity of Queensland · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Critically ill patients can display markedly abnormal physiological parameters compared with those in ward-based or ambulatory settings. As a function of both the underlying inflammatory state and the interventions provided, these patients manifest substantial changes in their cardiovascular and renal function that are not always immediately discernable using standard diagnostic tests. Impaired renal function is well documented among such individuals; however, even patients with normal serum creatinine concentrations might display elevated glomerular filtration rates, a phenomenon we have termed augmented renal clearance (ARC). This finding has important ramifications for the accurate dosing of renally eliminated drugs, given that most pharmaceutical dosing regimens were validated outside the critical care environment. Empirical approaches to dosing are unlikely to achieve therapeutic drug concentrations in patients with ARC, placing them at risk of suboptimal drug exposure and potential treatment failure. With an increasing appreciation of this phenomenon, alternative dosing strategies will need to be investigated.

Indexed as

Acute Kidney InjuryAnti-Bacterial AgentsAnticoagulantsCritical CareCritical IllnessGlomerular Filtration RateHumansKidneyRisk FactorsAnti-Bacterial AgentsAnticoagulants

Identifiers

PMID21769107
OpenAlexW2006314650

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.