ArticleIntensive care medicine2014
The impact of using estimated GFR versus creatinine clearance on the evaluation of recovery from acute kidney injury in the ICU.
Article in Intensive care medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 1 of them a synthesis that pooled it.
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Who cites it
41 citing papers in PubMed, 1 synthesis or guideline pooled it, 93 citations in OpenAlex.
- Serum Cystatin C as a predictor of acute kidney injury in neonates: a meta-analysis.Jornal de pediatriaPooled it
- Development and validation of the creatinine clearance predictor machine learning models in critically ill adults.Critical care (London, England) · 2023Trial
- Association between creatinine clearance and lumbar bone mineral density in Chinese patients with osteoporotic fractures: a retrospective cross-sectional study.Frontiers in endocrinology · 2026Article
- Renal Outcomes After Lung or Combined Heart-Lung Transplantation in Pulmonary Hypertension.Pulmonary circulation · 2025Article
- Association between creatinine clearance and mortality in Chinese patients with osteoporotic fractures: a retrospective cohort study.Frontiers in medicine · 2025Article
- Association between phase angle and daily creatinine excretion changes in critically ill patients: an approach to muscle mass.Frontiers in physiology · 2024Article
- Long-Term Tailor-Made Exercise Intervention Reduces the Risk of Developing Cardiovascular Diseases and All-Cause Mortality in Patients with Diabetic Kidney Disease.Journal of clinical medicine · 2023Article
- Article
- Effectiveness of Plasma and Urine Neutrophil Gelatinase-Associated Lipocalin for Predicting Acute Kidney Injury in High-Risk Patients.Annals of laboratory medicine · 2021Article
- Effects of early high-dose erythropoietin on acute kidney injury following cardiac arrest: exploratoryClinical kidney journal · 2020Article
- The urea-creatinine ratio as a novel biomarker of critical illness-associated catabolism.Intensive care medicine · 2019Article
- Molecular nephrology: types of acute tubular injury.Nature reviews. Nephrology · 2019Review
- Recovery from acute kidney injury as a potent predictor of survival and good neurological outcome at discharge after out-of-hospital cardiac arrest.Critical care (London, England) · 2019Article
- Urinary creatinine excretion is related to short-term and long-term mortality in critically ill patients.Intensive care medicine · 2018Article
- The 10 false beliefs in adult critical care nephrology.Intensive care medicine · 2018Article
- Acute kidney injury and mild therapeutic hypothermia in patients after cardiopulmonary resuscitation - a post hoc analysis of a prospective observational trial.Critical care (London, England) · 2018Observational
- Article
- Creatinine- and Cystatin C-Based Incidence of Chronic Kidney Disease and Acute Kidney Disease in AKI Survivors.Critical care research and practice · 2018Article
- Short-term renal outcomes following acute kidney injury among dengue patients: A follow-up analysis from large prospective cohort.PloS one · 2018Article
- Acute kidney injury in the ICU: from injury to recovery: reports from the 5th Paris International Conference.Annals of intensive care · 2017Review
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo quantify the error in evaluating recovery from acute kidney injury (AKI) with estimated GFR (eGFR) in relation to ICU stay.
methodsSecondary analysis performed on the database of the EPaNIC trial. In a cohort of patients who developed AKI during ICU stay we compared eGFR with measured creatinine clearance (Clcr) at ICU discharge. Recovery of kidney function was assessed by comparison with baseline eGFR and the accuracy of eGFR to detect "potential CKD status" defined by Clcr was quantified. The same analysis was performed in subgroups with different ICU stay. Multivariate regression was performed to determine independent predictors of the eGFR-Clcr difference.
resultsA total of 757 patients were included. The bias (limits of agreement (LOA)) between eGFR and Clcr at ICU discharge related to ICU stay, increasing from +1.3 (-37.4/+40) ml/min/1.73 m(2) in patients with short stay to +34.7 (-54.4/+123.8) ml/min/1.73 m(2) in patients with ICU stay of more than 14 days. This resulted in a significantly different incidence of complete recovery with the two evaluation methods and reduced sensitivity to detect "potential CKD status" with eGFR in patients with prolonged ICU stay. Independent predictors of the bias included creatinine excretion on the last day in ICU, baseline eGFR, ICU stay, gender, and age.
conclusionCompared to Clcr, discharge eGFR results in overestimation of renal recovery in patients with prolonged ICU stay and in reduced accuracy of "CKD staging". Since age, gender and race do not change during ICU stay the same conclusion can be drawn with regard to plasma creatinine.
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