ORIGINAL ARTICLE

Evaluation of the accuracy of Bio-impedance in predicting creatinine clearance in ICU patients with acute kidney injury; Comparison with measured creatinine clearance and calculated by formulas

Mohammad Sistanizad, Mehran Kouchek, Mir Mohammad Miri, Sayyed Rasoul Sajjadi, Helena Azimi, Reza Goharani

Mohammad Sistanizad
Department of Clinical Pharmacy, Faculty of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2: Department of Anesthesiology and Critical Care, Imam Hussein Teaching and Educational Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Mehran Kouchek
Department of Anesthesiology and Critical Care, Imam Hussein Teaching and Educational Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Mir Mohammad Miri
Department of Anesthesiology and Critical Care, Imam Hussein Teaching and Educational Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Sayyed Rasoul Sajjadi
Department of Anesthesiology and Critical Care, Imam Hussein Teaching and Educational Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Helena Azimi
Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Reza Goharani
Department of Anesthesiology and Critical Care, Imam Hussein Teaching and Educational Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Email: rezagoharani@gmail.com
Online First: September 19, 2017 | Cite this Article
Sistanizad, M., Kouchek, M., Miri, M., Sajjadi, S., Azimi, H., Goharani, R. 2017. Evaluation of the accuracy of Bio-impedance in predicting creatinine clearance in ICU patients with acute kidney injury; Comparison with measured creatinine clearance and calculated by formulas. Bali Medical Journal 6(3): 690-695. DOI:10.15562/bmj.v6i3.758


Introduction

It is still of top priority to find a method to measure creatinine clearance in patients with acute kidney injury (AKI) in order to regulate drug dosage and avoid treatment failure. Therefore, the present study was an attempt to compare creatinine clearance measured with 6-hour urine and creatinine clearance measured by formulas and bio-impedance method in patients with AKI hospitalized in ICU.

Materials and methods

In the present prospective cross-sectional study, 28 adult patients with an increase in serum creatinine of at least 0.3 according to AKIN criteria and admitted in ICU of Imam Hussein Hospital were selected as the study sample. For all of the patients who entered the study, creatinine clearance was measured by collecting 6-hour urine through electrical bio-impedance method or formulas of Cockcroft and Gault, MDRD, and CKD-EPI. After the required data were collected, they were recorded in pre-prepared checklists, and finally fed into a software to be statistically analyzed. At last, the obtained creatinine clearances were compared with those measured by collecting 6-hour urine so as to specify the best formula or method to determine creatinine clearance in patients with AKI.

Results

The results showed that the bias values of bio-impedance compared to 6-hour urinary clearance, MDRD, Cockcroft, and CKD-EPI were respectively 6.34, 3.31, 5.01, and 15.14. Also, error values of bio-impedance compared to 6-hour urinary clearance, MDRD, Cockcroft, and CKD-EPI were respectively 140%, 28%, 60%, and 47%. The internal consistency of the bio-impedance values by the above methods was respectively 0.782, 0.983, 0.939, and 0.893. According to the results of the present study, bio-impedance did not have an appropriate capacity to measure creatinine clearance or estimate GFR in patients with AKI.

Conclusion

According to the obtained results, it can be held that none of the formulas MDRD, Cockcroft and Gault, and CKD-EPI formed an acceptable relationship with measuring creatinine clearance by collecting 6-hour urine as a reference method. Therefore, this group of patients needs to figure out more precise and specific methods to measure creatinine clearance and glomerular filtration.
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