ARC - Augmented renal clearance

Udy, Andrew, Boots, Robert J., Putt, Michael and Lipman, Jeffrey (2011) ARC - Augmented renal clearance. Current Pharmaceutical Biotechnology, 12 12: 2020-2029. doi:10.2174/138920111798808446

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Author Udy, Andrew
Boots, Robert J.
Putt, Michael
Lipman, Jeffrey
Title ARC - Augmented renal clearance
Journal name Current Pharmaceutical Biotechnology   Check publisher's open access policy
ISSN 1389-2010
Publication date 2011-05-10
Sub-type Critical review of research, literature review, critical commentary
DOI 10.2174/138920111798808446
Volume 12
Issue 12
Start page 2020
End page 2029
Total pages 10
Place of publication Bussum, Netherlands
Publisher Bentham Science Publishers
Collection year 2012
Language eng
Abstract In-hospital and intensive care unit mortality rates for sepsis remain un-acceptably high, and have prompted the publication of international guidelines on best practice. Crucial to this is the application of early appropriate antibacterial therapy, in the correct dose. However, antibacterial regimes in this setting have largely been extrapolated from those in healthy volunteers, and fail to consider the unique pathophysiology and treatment provided to this population. As such, augmented renal clearance (ARC) - the enhanced renal elimination of circulating solute - is likely to be one of the more common physiological changes encountered in this setting, although to date remains largely under-appreciated. Significantly this may alter the pharmacokinetics of many routinely prescribed agents in this setting, pre-disposing to sub-therapeutic levels or treatment failure. This review paper examines this phenomenon in detail, providing a summary of the likely underlying mechanisms, those patients at greatest risk, and the implications for antibacterial dosing in the critically ill.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes 2011 May 10. [Epub ahead of print]

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2012 Collection
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 10 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 9 times in Scopus Article | Citations
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Created: Fri, 09 Sep 2011, 16:19:43 EST by Sia Athanasas on behalf of Anaesthesiology and Critical Care - RBWH