Development of glomerular filtration rate monitor based on creatinine kinetic modelling in critically ill patients
Background: Creatinine kinetic denotes that under steady state, creatinine production (G) equals to creatinine excretion rate (E), and if production exceeds excretion, GFR is impaired. Kinetic estimate of GFR (keGFR) offers a more accurate estimate of GFR in the acute settings with rapidly changing...
| Main Authors: | , , , , , |
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| Format: | Monograph |
| Language: | English |
| Published: |
2018
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| Subjects: | |
| Online Access: | http://irep.iium.edu.my/67922/ http://irep.iium.edu.my/67922/1/Profile%20of%20Final%20Report_FRGS-15-235-0476.pdf |
| _version_ | 1848786852806393856 |
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| author | Md Ralib, Azrina Mat Nor, Mohd Basri Mohamed, Rozilah @ Abdul Hadi Abdullah, Nor Zamzila Jamaludin, Ummu Kulthum Dzaharudin, Fatimah |
| author_facet | Md Ralib, Azrina Mat Nor, Mohd Basri Mohamed, Rozilah @ Abdul Hadi Abdullah, Nor Zamzila Jamaludin, Ummu Kulthum Dzaharudin, Fatimah |
| author_sort | Md Ralib, Azrina |
| building | IIUM Repository |
| collection | Online Access |
| description | Background: Creatinine kinetic denotes that under steady state, creatinine production (G) equals to creatinine excretion rate (E), and if production exceeds excretion, GFR is impaired. Kinetic estimate of GFR (keGFR) offers a more accurate estimate of GFR in the acute settings with rapidly changing kidney functions.
Objectives: We evaluated keGFR and E/eG ratio in diagnosis of AKI and its recovery. We also compared their diagnostic ability to the plasma Cystatin C and NGAL.
Methods: This was a prospective observational study of critically ill patients. Inclusion criteria were patients >18 years old with sepsis and procalcitonin>0.5ng/ml.
Results: 70 patients were recruited. keGFR had the least bias with the mean differences nearest to zero (-18 ml/min) when compared to CrCl. keGFRCr and keGFRCysC were strongly diagnostic of AKI with AUC of 0.93 (0.87 to 0.99). In 39 patients with AKI, 15 recovered within 3 days. In these cases, E/eG ratio strongly predicted AKI recovery (AUC 0.83 (0.69 to 0.97)). The AUC of plasma NGAL were highest for AKI diagnosed by keGFR on Day 1 and Day 2, and by E/eG ratio on Day 3.
Conclusions: In critically ill patients with sepsis, keGFRCr and keGFRCysC had the least bias and fair precision when compared to CrCl. They diagnosed AKI with cut-off points of 77 and 86 ml/min respectively. E/eG ratio was useful for prediction of recovery in patients with AKI. NGAL best diagnosed AKI by keGFR and E/eG ratio. |
| first_indexed | 2025-11-14T17:15:37Z |
| format | Monograph |
| id | iium-67922 |
| institution | International Islamic University Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T17:15:37Z |
| publishDate | 2018 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | iium-679222022-04-12T02:57:06Z http://irep.iium.edu.my/67922/ Development of glomerular filtration rate monitor based on creatinine kinetic modelling in critically ill patients Md Ralib, Azrina Mat Nor, Mohd Basri Mohamed, Rozilah @ Abdul Hadi Abdullah, Nor Zamzila Jamaludin, Ummu Kulthum Dzaharudin, Fatimah R Medicine (General) Background: Creatinine kinetic denotes that under steady state, creatinine production (G) equals to creatinine excretion rate (E), and if production exceeds excretion, GFR is impaired. Kinetic estimate of GFR (keGFR) offers a more accurate estimate of GFR in the acute settings with rapidly changing kidney functions. Objectives: We evaluated keGFR and E/eG ratio in diagnosis of AKI and its recovery. We also compared their diagnostic ability to the plasma Cystatin C and NGAL. Methods: This was a prospective observational study of critically ill patients. Inclusion criteria were patients >18 years old with sepsis and procalcitonin>0.5ng/ml. Results: 70 patients were recruited. keGFR had the least bias with the mean differences nearest to zero (-18 ml/min) when compared to CrCl. keGFRCr and keGFRCysC were strongly diagnostic of AKI with AUC of 0.93 (0.87 to 0.99). In 39 patients with AKI, 15 recovered within 3 days. In these cases, E/eG ratio strongly predicted AKI recovery (AUC 0.83 (0.69 to 0.97)). The AUC of plasma NGAL were highest for AKI diagnosed by keGFR on Day 1 and Day 2, and by E/eG ratio on Day 3. Conclusions: In critically ill patients with sepsis, keGFRCr and keGFRCysC had the least bias and fair precision when compared to CrCl. They diagnosed AKI with cut-off points of 77 and 86 ml/min respectively. E/eG ratio was useful for prediction of recovery in patients with AKI. NGAL best diagnosed AKI by keGFR and E/eG ratio. 2018-11-22 Monograph NonPeerReviewed application/pdf en http://irep.iium.edu.my/67922/1/Profile%20of%20Final%20Report_FRGS-15-235-0476.pdf Md Ralib, Azrina and Mat Nor, Mohd Basri and Mohamed, Rozilah @ Abdul Hadi and Abdullah, Nor Zamzila and Jamaludin, Ummu Kulthum and Dzaharudin, Fatimah (2018) Development of glomerular filtration rate monitor based on creatinine kinetic modelling in critically ill patients. UNSPECIFIED. UNSPECIFIED. (Unpublished) |
| spellingShingle | R Medicine (General) Md Ralib, Azrina Mat Nor, Mohd Basri Mohamed, Rozilah @ Abdul Hadi Abdullah, Nor Zamzila Jamaludin, Ummu Kulthum Dzaharudin, Fatimah Development of glomerular filtration rate monitor based on creatinine kinetic modelling in critically ill patients |
| title | Development of glomerular filtration rate monitor based on creatinine kinetic modelling in critically ill patients |
| title_full | Development of glomerular filtration rate monitor based on creatinine kinetic modelling in critically ill patients |
| title_fullStr | Development of glomerular filtration rate monitor based on creatinine kinetic modelling in critically ill patients |
| title_full_unstemmed | Development of glomerular filtration rate monitor based on creatinine kinetic modelling in critically ill patients |
| title_short | Development of glomerular filtration rate monitor based on creatinine kinetic modelling in critically ill patients |
| title_sort | development of glomerular filtration rate monitor based on creatinine kinetic modelling in critically ill patients |
| topic | R Medicine (General) |
| url | http://irep.iium.edu.my/67922/ http://irep.iium.edu.my/67922/1/Profile%20of%20Final%20Report_FRGS-15-235-0476.pdf |