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Augmented renal clearance

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https://www.readbyqxmd.com/read/28444760/vancomycin-levels-are-frequently-subtherapeutic-in-critically-ill-patients-a-prospective-observational-study
#1
V Bakke, H Sporsem, E Von der Lippe, I Nordøy, Y Lao, H C Nyrerød, L Sandvik, K R Hårvig, J F Bugge, E Helset
BACKGROUND: Appropriate utilization of vancomycin is important to attain therapeutic targets while avoiding clinical failure and the development of antimicrobial resistance. Our aim was to observe the use of vancomycin in an intensive care population, with the main focus on achievement of therapeutic serum concentrations (15-20 mg/l) and to evaluate how this was influenced by dose regimens, use of guidelines and therapeutic drug monitoring. METHODS: A prospective observational study was carried out in the intensive care units at two tertiary hospitals in Norway...
April 25, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28363806/novel-role-of-insulin-in-the-regulation-of-glucose-excretion-by-mourning-doves-zenaida-macroura
#2
Karen L Sweazea, Eldon J Braun, Richard Sparr
In mammals, insulin primarily lowers plasma glucose (PGlu) by increasing its uptake into tissues. Studies have also shown that insulin lowers PGlu in mammals by modulating glomerular filtration rate (GFR). Birds have naturally high PGlu and, although insulin administration significantly decreases glucose concentrations, birds are resistant to insulin-mediated glucose uptake into tissues. Since prior work has not examined the effects of insulin on GFR in birds, the purpose of the present study was to assess whether insulin can augment renal glucose excretion and thereby lower PGlu...
February 20, 2017: Zoology: Analysis of Complex Systems, ZACS
https://www.readbyqxmd.com/read/28286115/association-between-augmented-renal-clearance-and-clinical-outcomes-in-patients-receiving-%C3%AE-lactam-antibiotic-therapy-by-continuous-or-intermittent-infusion-a-nested-cohort-study-of-the-bling-ii-randomised-placebo-controlled-clinical-trial
#3
Andrew A Udy, Joel M Dulhunty, Jason A Roberts, Joshua S Davis, Steven A R Webb, Rinaldo Bellomo, Charles Gomersall, Charudatt Shirwadkar, Glenn M Eastwood, John Myburgh, David L Paterson, Therese Starr, Sanjoy K Paul, Jeffrey Lipman
Augmented renal clearance (ARC) is known to influence β-lactam antibiotic pharmacokinetics. This substudy of the BLING-II trial aimed to explore the association between ARC and patient outcomes in a large randomised clinical trial. BLING-II enrolled 432 participants with severe sepsis randomised to receive β-lactam therapy by continuous or intermittent infusion. An 8-h creatinine clearance (CLCr) measured on Day 1 was used to identify ARC, defined as CLCr ≥ 130 mL/min. Patients receiving any form of renal replacement therapy were excluded...
March 9, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28264846/substantial-impact-of-altered-pharmacokinetics-in-critically-ill-patients-on-the-antibacterial-effects-of-meropenem-evaluated-via-the-dynamic-hollow-fiber-infection-model
#4
Phillip J Bergen, Jürgen B Bulitta, Carl M J Kirkpatrick, Kate E Rogers, Megan J McGregor, Steven C Wallis, David L Paterson, Roger L Nation, Jeffrey Lipman, Jason A Roberts, Cornelia B Landersdorfer
Critically ill patients frequently have substantially altered pharmacokinetics compared to non-critically ill patients. We investigated the impact of pharmacokinetic alterations on bacterial killing and resistance for commonly used meropenem dosing regimens. A Pseudomonas aeruginosa isolate (MICmeropenem 0.25 mg/liter) was studied in the hollow-fiber infection model (inoculum ∼10(7.5) CFU/ml; 10 days). Pharmacokinetic profiles representing critically ill patients with augmented renal clearance (ARC), normal, or impaired renal function (creatinine clearances of 285, 120, or ∼10 ml/min, respectively) were generated for three meropenem regimens (2, 1, and 0...
May 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28223378/population-pharmacokinetic-analysis-of-doripenem-after-intravenous-infusion-in-korean-patients-with-acute-infections
#5
Dong-Hwan Lee, Yong Kyun Kim, Kyubok Jin, Myoung Joo Kang, Young-Don Joo, Yang Wook Kim, Young Soo Moon, Jae-Gook Shin, Sungmin Kiem
We investigated the population pharmacokinetics (PK) of doripenem in Korean patients with acute infections and determined an appropriate dosing regimen using a Monte Carlo simulation for predicting pharmacodynamics (PD). Patients (n = 37) with a creatinine clearance (CLCR) of 20 to 50 ml/min or >50 ml/min who received a 250-mg or 500-mg dose of doripenem over the course of 1 h every 8 h, respectively, were included in this study. Blood samples were taken predosing and 0 h, 0.5 h, and 4 to 6 h after the fourth infusion...
May 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28129261/identifying-augmented-renal-clearance-in-trauma-patients-validation-of-the-augmented-renal-clearance-in-trauma-intensive-care-scoring-system
#6
Jeffrey F Barletta, Alicia J Mangram, Marilyn Byrne, Joseph F Sucher, Alexzandra K Hollingworth, Francis R Ali-Osman, Gina R Shirah, Michael Haley, James K Dzandu
BACKGROUND: Augmented renal clearance (ARC) is common in trauma patients and associated with subtherapeutic antimicrobial concentrations. This study reported the incidence of ARC, identified ARC risk factors, and described a model to predict ARC (i.e., ARCTIC) that is specific to trauma patients. METHODS: Consecutive trauma patients who were admitted to the intensive care unit between March 2015 and January 2016 and had a measured creatinine clearance (CrCl) were considered for inclusion...
April 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28062568/renal-collectrin-protects-against-salt-sensitive-hypertension-and-is-downregulated-by-angiotensin-ii
#7
Pei-Lun Chu, Joseph C Gigliotti, Sylvia Cechova, Gabor Bodonyi-Kovacs, Fang Chan, Donna Lee Ralph, Nancy Howell, Kambiz Kalantari, Alexander L Klibanov, Robert M Carey, Alicia A McDonough, Thu H Le
Collectrin, encoded by the Tmem27 gene, is a transmembrane glycoprotein with approximately 50% homology with angiotensin converting enzyme 2, but without a catalytic domain. Collectrin is most abundantly expressed in the kidney proximal tubule and collecting duct epithelia, where it has an important role in amino acid transport. Collectrin is also expressed in endothelial cells throughout the vasculature, where it regulates L-arginine uptake. We previously reported that global deletion of collectrin leads to endothelial dysfunction, augmented salt sensitivity, and hypertension...
January 6, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28013453/pk-pd-target-attainment-with-ceftolozane-tazobactam-using-monte-carlo-simulation-in-patients-with-various-degrees-of-renal-function-including-augmented-renal-clearance-and-end-stage-renal-disease
#8
Alan J Xiao, Luzelena Caro, Myra W Popejoy, Jennifer A Huntington, Ravina Kullar
INTRODUCTION: Ceftolozane/tazobactam is an antibacterial agent with potent in vitro activity against Gram-negative pathogens, including many extended-spectrum β-lactamase-producing Enterobacteriaceae and drug-resistant Pseudomonas aeruginosa. Because ceftolozane/tazobactam is primarily excreted renally, appropriate dose adjustments are needed for patients with renal impairment. Monte Carlo simulations were used to determine the probability of pharmacokinetic/pharmacodynamic target attainment for patients with varying degrees of renal function, including augmented renal clearance (ARC) and end-stage renal disease (ESRD) with hemodialysis...
March 2017: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/27904098/relationship-between-pk-pd-of-cefepime-and-clinical-outcome-in-febrile-neutropenic-patients-with-normal-renal-function
#9
Yoshiko Yamashita, Hidekazu Kamiyama, Asuka Yamamoto, Hiroki Kanoh, Yoshimitsu Yuhki, Akira Ueda, Yukari Kawamoto, Yoshikazu Gotoh, Satoshi Yamamoto
 The efficacy of cefepime (CFPM) is known to depend on the ratio of the time that the serum levels exceed the minimum inhibitory concentration (MIC) to the dosing interval (%T>MIC). The objective of this study was to clarify the relation between %T>MIC and clinical outcome of CFPM, and to identify the optimal dosage regimen. We investigated the outcome of CFPM treatment for febrile neutropenia (FN) patients with normal renal function. Treatment success was defined as the completion of FN therapy with CFPM only...
2016: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
https://www.readbyqxmd.com/read/27850300/661-pk-pd-and-safety-of-3-g-ceftolozane-tazobactam-in-critically-ill-augmented-renal-clearance-patients
#10
Luzelena Caro, Kajal Larson, David Nicolau, Jan DeWaele, Joseph Kuti, Elaine Gadzicki, Brian Yu, Elizabeth Rhee
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27771187/optimising-meropenem-dosing-in-critically-ill-australian-indigenous-patients-with-severe-sepsis
#11
Danny Tsai, Penelope Stewart, Rajendra Goud, Stephen Gourley, Saliya Hewagama, Sushena Krishnaswamy, Steven C Wallis, Jeffrey Lipman, Jason A Roberts
Currently there are no pharmacokinetic (PK) data to guide antibiotic dosing in critically ill Australian Indigenous patients with severe sepsis. This study aimed to determine whether the population pharmacokinetics of meropenem were different between critically ill Australian Indigenous and critically ill Caucasian patients. Serial plasma and urine samples as well as clinical and demographic data were collected over two dosing intervals from critically ill Australian Indigenous patients. Plasma meropenem concentrations were assayed by validated chromatography...
November 2016: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/27754186/sp-04-1-the-role-of-natriuretic-peptides-in-the-pathogenesis-of-cardiovascular-diseases
#12
Zhanna Kobalava
The burden of cardiovascular diseases (CVD) in general and heart failure (HF) in particular continues to increase worldwide. CVD are major contributors to death and morbidity and recognized as important drivers of healthcare expenditure. Chronic overactivity of the renin-angiotensin-aldosterone system (RAAS) plays a key role in human hypertension and HF pathophysiology. RAAS is fundamental in the overall regulation of cardiovascular homeostasis through the actions of hormones, which regulate vascular tone, and specifically blood pressure through vasoconstriction and renal sodium and water retention...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27731492/prolonged-administration-of-%C3%AE-lactam-antibiotics-a-comprehensive-review-and-critical-appraisal
#13
Michael Osthoff, Martin Siegemund, Gianmarco Balestra, Mohd Hafiz Abdul-Aziz, Jason A Roberts
Prolonged infusion of β-lactam antibiotics as either extended (over at least 2 hours) or continuous infusion is increasingly applied in intensive care units around the world in an attempt to optimise treatment with this most commonly used class of antibiotics, whose effectiveness is challenged by increasing resistance rates. The pharmacokinetics of β-lactam antibiotics in critically ill patients is profoundly altered secondary to an increased volume of distribution and the presence of altered renal function, including augmented renal clearance...
2016: Swiss Medical Weekly
https://www.readbyqxmd.com/read/27729984/augmented-renal-clearance-in-japanese-intensive-care-unit-patients-a-prospective-study
#14
Yasumasa Kawano, Shinichi Morimoto, Yoshito Izutani, Kentaro Muranishi, Hironari Kaneyama, Kota Hoshino, Takeshi Nishida, Hiroyasu Ishikura
BACKGROUND: Augmented renal clearance (ARC) of circulating solutes and drugs has been recently often reported in intensive care unit (ICU) patients. However, only few studies on ARC have been reported in Japan. The aims of this pilot study were to determine the prevalence and risk factors for ARC in Japanese ICU patients with normal serum creatinine levels and to evaluate the association between ARC and estimated glomerular filtration rate (eGFR) calculated using the Japanese equation...
2016: Journal of Intensive Care
https://www.readbyqxmd.com/read/27681114/augmented-renal-clearance-in-patients-with-febrile-neutropenia-is-associated-with-increased-risk-for-subtherapeutic-concentrations-of-vancomycin
#15
Keita Hirai, Hidetoshi Ishii, Takayuki Shimoshikiryo, Tatsuki Shimomura, Daiki Tsuji, Kazuyuki Inoue, Toshihiko Kadoiri, Kunihiko Itoh
BACKGROUND: Augmented renal clearance (ARC) has frequently been observed in critically ill patients. The risk factors for ARC in patients, including those in the general ward, and their influences on vancomycin (VCM) treatment remain unclear. The aims of this study were to investigate the risk factors for ARC and to evaluate the influence of ARC on the pharmacokinetic parameters of VCM. METHODS: This study included a total of 292 patients with VCM treatment who had normal serum creatinine concentrations...
December 2016: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/27643143/sp-04-1-the-role-of-natriuretic-peptides-in-the-pathogenesis-of-cardiovascular-diseases
#16
Zhanna Kobalava
The burden of cardiovascular diseases (CVD) in general and heart failure (HF) in particular continues to increase worldwide. CVD are major contributors to death and morbidity and recognized as important drivers of healthcare expenditure. Chronic overactivity of the renin-angiotensin-aldosterone system (RAAS) plays a key role in human hypertension and HF pathophysiology. RAAS is fundamental in the overall regulation of cardiovascular homeostasis through the actions of hormones, which regulate vascular tone, and specifically blood pressure through vasoconstriction and renal sodium and water retention...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27586127/intravenous-antibiotic-and-antifungal-agent-pharmacokinetic-pharmacodynamic-dosing-in-adults-with-severe-burn-injury
#17
REVIEW
Jason M Cota, Alireza FakhriRavari, Matthew P Rowan, Kevin K Chung, Clinton K Murray, Kevin S Akers
PURPOSE: Despite advances in the care of patients with severe burn injury, infection-related morbidity and mortality remain high and can potentially be reduced with antimicrobial dosing optimized for the infecting pathogen. However, anti-infective dose selection is difficult because of the highly abnormal physiologic features of burn patients, which can greatly affect the pharmacokinetic (PK) disposition of these agents. We review published PK data from burn patients and offer evidence-based dosing recommendations for antimicrobial agents in burn-injured patients...
September 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27547968/maternal-fat-feeding-augments-offspring-nephron-endowment-in-mice
#18
Stacey Hokke, Victor G Puelles, James A Armitage, Karen Fong, John F Bertram, Luise A Cullen-McEwen
Increasing consumption of a high fat 'Western' diet has led to a growing number of pregnancies complicated by maternal obesity. Maternal overnutrition and obesity have health implications for offspring, yet little is known about their effects on offspring kidney development and renal function. Female C57Bl6 mice were fed a high fat diet (HFD, 21% fat) or matched normal fat diet (NFD, 6% fat) for 6 weeks prior to pregnancy and throughout gestation and lactation. HFD dams were overweight and glucose intolerant prior to mating but not in late gestation...
2016: PloS One
https://www.readbyqxmd.com/read/27546217/comparison-of-the-pharmacokinetics-of-vancomycin-in-neurosurgical-and-non-neurosurgical-patients
#19
A Jeong Kim, Ju-Yeun Lee, Soo An Choi, Wan Gyoon Shin
Although vancomycin concentrations in neurosurgical patients tend to be lower following standard dosing compared with other patient populations, factors influencing vancomycin pharmacokinetics in neurosurgical patients are poorly understood. In this study, pharmacokinetic (PK) parameters in neurosurgical and non-neurosurgical patients were compared. Furthermore, factors influencing vancomycin PK alterations, including those known to augment renal clearance, were determined. Routine therapeutic drug monitoring data from neurosurgical and non-neurosurgical patients were retrospectively collected...
October 2016: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/27533906/the-importance-of-empiric-antibiotic-dosing-in-critically-ill-trauma-patients-are-we-under-dosing-based-on-augmented-renal-clearance-and-inaccurate-renal-clearance-estimates
#20
Jeffrey F Barletta, Alicia J Mangram, Marilyn Byrne, Alexzandra K Hollingworth, Joseph F Sucher, Francis R Ali-Osman, Gina R Shirah, James K Dzandu
BACKGROUND: An accurate assessment of creatinine clearance (CrCl) is essential when dosing medications in critically ill trauma patients. Trauma patients are known to experience augmented renal clearance (i.e., CrCl ≥130 mL/min), and the use of CrCl estimations may be inaccurate leading to under-/over-dosing of medications. As such, our Level I trauma center began using measured CrCl from timed urine collections to better assess CrCl. This study sought to determine the prevalence of augmented renal clearance and the accuracy of calculated CrCl in critically ill trauma patients...
December 2016: Journal of Trauma and Acute Care Surgery
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