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2018 (v.26 no.3)

Translational and Clinical Pharmacology

Korean Society for Clinical Pharmacology and Therapeutics
ISSN: 2289-0882

  • Augmented renal clearance

    Arthur J. Atkinson, Jr.

    TCP | v.26, no.3, pp.111-114, Sep, 2018


    Adding to the complexity of caring for critically ill patients is the fact that many of them have a
    creatinine clearance that exceeds 130 mL/min/1.73 m2. This phenomenon, termed augmented renal
    clearance (ARC), has only recently been widely recognized and its pathogenesis remains incompletely
    understood. However, ARC has been shown to result in increased dose requirements for
    drugs that are primarily eliminated by renal excretion, including many antimicrobial agents and
    enoxaparin. Recognition of ARC is hampered by the fact that the standard creatinine-based equations
    used to estimate renal function are not accurate in this clinical setting and the diagnosis is best
    established using both serum and urine creatinine measurements to calculate clearance. So a high
    index of clinical suspicion and awareness is usually required before this step is taken to confirm the
    diagnosis of ARC.


    Antimicrobial agents, Augmented renal clearance, Critically ill patients, Drug dose requirements