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Augmented Renal Clearance Criteria:
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Augmented Renal Clearance (ARC) is defined as enhanced renal elimination of circulating solutes, typically identified when creatinine clearance exceeds 130 mL/min/1.73m². This condition is commonly observed in critically ill patients and can significantly impact drug pharmacokinetics.
The calculator uses the standard ARC criteria:
Where:
Explanation: Values above 130 mL/min/1.73m² indicate augmented renal clearance, which may require dosage adjustments for renally eliminated medications.
Details: ARC is particularly important in critical care settings as it can lead to subtherapeutic drug concentrations, treatment failure, and potential development of antimicrobial resistance due to enhanced clearance of antibiotics and other medications.
Tips: Enter the calculated creatinine clearance value in mL/min/1.73m². The calculator will determine if augmented renal clearance is present based on the standard threshold of 130 mL/min/1.73m².
Q1: What patient populations are at risk for ARC?
A: Critically ill patients, particularly those with sepsis, trauma, burns, or systemic inflammatory response syndrome are commonly affected by augmented renal clearance.
Q2: How does ARC affect drug dosing?
A: ARC can significantly increase clearance of renally eliminated drugs, potentially requiring higher doses, more frequent administration, or therapeutic drug monitoring to ensure adequate exposure.
Q3: What methods are used to measure CrCl for ARC assessment?
A: Both measured (24-hour urine collection) and estimated (using equations like Cockcroft-Gault) creatinine clearance can be used, though measured values are preferred for accuracy.
Q4: Are there limitations to ARC assessment?
A: Yes, factors like fluid resuscitation, age, muscle mass, and concurrent renal injury can affect CrCl measurements and ARC interpretation.
Q5: How long does ARC typically persist?
A: The duration varies but ARC often resolves as the patient's critical illness improves, requiring ongoing monitoring and dose adjustments throughout treatment.