Tus nqi ntawm Kinetic Glomerular Filtration Rate Estimation On Tshuaj Dosing nyob rau hauv mob raum mob

Hu rau:joanna.jia@wecistanche.com/ WhatsApp: 008618081934791

Yuengling D. KwongID1*, Sheldon Chen2, Rima Bouajram3, Fanny Li3, Michael A. Matthay4, Kala M. Mehta5, David V. Glidden5, Kathleen D. Liu1,6

1 Department of Medicine, Division of Nephrology, University of California ntawm San Francisco School of Medicine, San Francisco, CA, United States of America, 2 Department of Medicine, Division of Nephrology, MD Anderson, Houston, TX, United States of America, 3 Department of Pharmaceutical Services, University of California ntawm San Francisco Medical Center, San Francisco, CA, United States of America, 4 Department of Medicine, Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, University of California San Francisco School of Tshuaj, San Francisco, CA, United States of America, 5 Department of Epidemiology and Biostatistics, the University of California ntawm San Francisco School of Medicine, San Francisco, CA, United States of America, 6 Department of Anesthesia, Division of Critical Care Medicine , University of California ntawm San Francisco School of Medicine, San Francisco, CA, United States of America.

Citation: Kwong YD, Chen S, Bouajram R, Li F, Matthay MA, Mehta KM, et al. (2019) Tus nqi ntawmkinetic glomerular filtration tus nqi kwv yees ntawm cov tshuaj noj nyob rau hauv mob raum raug mob. PLoS ONE 14(11): e0225601. https://doi.org/10.1371/ phau ntawv journal. pone.0225601 Editor: Petter Bjornstad, University of Colorado Denver School of Medicine, UNITED STATES Tau txais: Lub Xya Hli 10, 2019, Txais: Kaum Ib Hlis 7, 2019, Luam tawm: Kaum Ib Hlis 26, 2019 Copyright: © 2019 Kwong et al. Qhov no yog ib tsab xov xwm qhib tau muab faib raws li cov ntsiab lus ntawm Creative Commons Attribution License, uas tso cai txwv tsis pub siv, faib, thiab luam tawm nyob rau hauv ib qho nruab nrab, muab tus thawj sau thiab qhov chaw raug tso cai. Cov ntaub ntawv muaj nyob: Cov ntaub ntawv hauv qab cov txiaj ntsig tau nthuav tawm hauv txoj kev tshawb fawb no muaj los ntawm National Heart, Lung, thiab Blood Institute ntawm (https://biolincc.nhlbi.nih.gov/studies/factt/). Cov Nyiaj Txiag: Cov haujlwm no tau txhawb nqa los ntawm National Institute of Diabetes thiab Digestive thiabKab mob raum(NIDDK) ntawm National Institutes of Health (NIH muab T32 DK007219 thiab F32DK118870 rau Dr. Kwong thiab 1K24DK113381 rau Dr. Liu) thiab American Society of Nephrology Donald E. Wesson Kev Sib Raug Zoo rau Dr. Kwong. Cov peev nyiaj ntawm txoj kev tshawb no tsis muaj lub luag haujlwm hauv kev kawm tsim, sau, txheeb xyuas, thiab txhais cov ntaub ntawv. Cov txiaj ntsig sib tw: Cov kws sau ntawv tau tshaj tawm tias tsis muaj kev sib tw muaj txiaj ntsig.

Abstract

Keeb kwm

Hauvmob raum raug mob(AKI), kev noj tshuaj raws li Cockcroft-Gault creatinine clearance (CrCl) lossisMob raum mobEpidemiology Collaboration (CKD-EPI) kwv yees glomerular filtration rates (eGFR) tsis siv tau thaum serum creatinine (SCr) tsis nyob hauv lub xeev khov kho. Lub hom phiaj ntawm txoj kev tshawb no yog txhawm rau txiav txim siab qhov cuam tshuam ntawm kev kwv yees kwv yees sib npaug uas suav nrog kev hloov pauv hauv SCrs ntawm kev siv tshuaj hauv cov neeg mob hnyav. lub raum

Cov txheej txheem

Peb tau siv cov ntaub ntawv los ntawm cov neeg koom nrog rau npe hauv NIH Acute Respiratory Distress Syndrome Network Fluid and Catheters Treatment Trial los simulate cov tshuaj siv tshuaj hloov pauv nrog rau daim ntawv thov ntawm kinetic kwv yees sib npaug tsim los ntawm Chen. Peb soj ntsuam seb kinetic kwv yees ntawmlub raum ua haujlwmyuav hloov hom tshuaj noj (*60, 30–59, 15–29, thiab<15ml in)="" compared="" with="" the="" use="" of="" crcl="" or="" ckd-epi="">

Cov txiaj ntsig

Kev siv kinetic CrCl thiab CKD-EPI eGFR ua rau muaj kev hloov pauv loj txaus hauv kev kwv yees lub raum ua haujlwm kom xav tau cov tshuaj noj rov ua dua tshiab hauv 19.3 feem pua ​​[95 CI 16.8 feem pua ​​-21.9 feem pua] thiab 23.4 feem pua ​​[95 feem pua ​​CI 20.7 feem pua ​​-26.1 feem pua] ntawm cov neeg koom, feem. Raws li kev cia siab, recategorization tshwm sim ntau zaus hauv cov neeg uas muaj AKI. Thaum peb tshuaj xyuas ib hnub rau cov neeg uas muaj AKI, kev noj tshuaj tsis sib haum xeeb tau pom hauv 8.5 feem pua ​​​​ntawm tag nrho cov hnub siv CG CrCl thiab 10.2 feem pua ​​​​ntawm tag nrho cov hnub siv CKD-EPI sib npaug piv nrog cov kinetic counterparts.

Xaus

Hauv cov neeg mob hnyav, kev siv kinetic kwv yees ntawmlub raum ua haujlwmcuam ​​tshuam rau kev noj tshuaj nyob rau hauv ib feem ntawm cov neeg koom nrog AKI. Kev siv cov kev kwv yees kinetic hauv kev kho mob yuav tsum txo qis qhov tshwm sim ntawm cov tshuaj toxicity thiab tsis txhob siv tshuaj subtherapeutic thaum lub raum rov qab.

Cistanchetubulosativ thaivraumkab mob, nyem qhov no kom tau txais cov qauv

Taw qhia

Mob raum raug mob(AKI) yog ib qho tshwm sim hauv cov neeg mob hauv tsev kho mob [1,2] thiab tau cuam tshuam nrog kev tuag ntau ntxiv thiab nyob ntev ntev [3]. Txawm hais tias cov lus txhais tshiab AKI suav nrog cov zis tso zis, AKI ib txwm tau txhais raws li kev hloov pauv hauv cov ntshav creatinine (SCr). Thaum AKI, thaum SCr hloov pauv, tus qauv kwv yees ntawm creatinine tshem tawm (CrCl) lossis kwv yees glomerular filtration rate (eGFR) tsis siv tau, vim tias cov kev sib npaug no xav tias SCr nyob ntawm lub xeev khov kho. Tsis tas li ntawd, kev hloov pauv hauv SCr tuaj yeem ua rau poob qab qhov kev hloov pauv ntawm lub raum ua haujlwm thiab yuav siv sijhawm ob peb hnub kom mus txog lub xeev khov kho thaum lub sijhawm txhim kho thiab rov qab los ntawm AKI. Yog li, kwv yees CrCl lossis eGFR tuaj yeem siab dua qhov tseeb GFR thaum AKI tab tom txhim kho ua rau kev siv tshuaj ntau dhau thiab qis dua qhov tseeb GFR thaum rov qab los, ua rau muaj kev noj tshuaj tsis txaus.

Qhov sib npaug [4–8] uas suav nrog tus nqi ntawm SCr hloov pauv tau raug thov kom kwv yees GFR tam sim ntawd thaum AKI. Txawm li cas los xij, lawv tsis tau siv dav. Nyob rau hauv 2013, Chen [9] tau tsim ib qho yooj yim algebraic kinetic eGFR (keGFR) equation. Hauv ntau pawg me me, qhov sib npaug no tau pom los kwv yees qhov tshwm sim ntawm lub raum, suav nrog kev ua haujlwm qeeb qeeb, kev lim ntshav-yuav tsum tau AKI, thiablub raum rov qabzoo dua los yog zoo li eGFR lossis tshiab biomarkers [10–15]. Raws li qhov tshwm sim ntawm cov kev tshawb fawb no, keGFR tau suav nrog hauv Cov Txheej Txheem Tshuaj Kho Mob hnyav ntawm AKI [16] thiab Cov Kab Mob Zoo Tshaj Plaws 16 Cov Haujlwm [17] ua ib qho cuab yeej xav tau kev tshawb fawb ntxiv [18]. Txawm li cas los xij, nws tsis tas yuav xav tsis thoob tias keGFR zoo dua rau cov qauv kwv yees ntawmlub raum ua haujlwmnyob rau hauv kev kwv yees qhov tshwm sim ntawm lub raum-qhov nruab nrab txij li thaum, los ntawm kev txhais, tus qub suav nrog kev hloov pauv hauv SCr, qhov tom kawg tsis yog.

Kinetic eGFR tej zaum yuav muaj kev cuam tshuam loj rau kev noj tshuaj thaum lub sijhawm txhim kho thiab rov qab los ntawm AKI. Txog niaj hnub no, ob txoj kev tshawb fawb [19,20] tau tshawb xyuas kev siv keGFR hauv kev siv tshuaj, tab sis tsis tau txheeb xyuas qhov loj ntawm kev hloov pauv uas yuav tshwm sim yog tias keGFR tau hloov pauv rau cov txheej txheem ib txwm siv hauv kev siv tshuaj. Kev hloov koob tshuaj raws li lub raum ua haujlwm tau siv keeb kwm siv Cockcroft-Gault (CG) CrCl txij li qhov no yog qhov tau pom zoo los ntawm Food and Drug Administration rau cov tshuaj noj tshuaj thaum lub sijhawm kev pom zoo tshuaj. Txawm li cas los xij, feem ntau cov ntaub ntawv kho mob hauv hluav taws xob qhia txog qhovMob raum mob-Epidemiology Collaboration (CKD-EPI) eGFR [21] nrog rau SCr. Qhov tseeb, FDA 2010 tsab ntawv qhia tau hloov kho kom suav nrog eGFR [22] ntxiv rau CrCl txhawm rau txheeb xyuas cov theem ntawm lub raum tsis zoo thiab npaj cov txiaj ntsig pharmacokinetic [23].

Peb kwv yees tias kev siv cov kev kwv yees kinetic ntawm lub raum kev ua haujlwm tuaj yeem cuam tshuam rau kev siv tshuaj hauv ntau tus neeg mob hnyav nrog rau lub raum ua haujlwm tsis zoo. Lub hom phiaj ntawm txoj kev kawm tam sim no. yog los tshuaj xyuas qhov zaus uas cov tshuaj hloov pauv yuav tshwm sim. Txhawm rau ntsuas qhov kev xav no, peb tau ua qhov simulation siv cov ntaub ntawv los ntawm qhov loj, tus yam ntxwv zoo, cov neeg mob hnyav nrog mob ua pa nyuaj siab (ARDS), vim tias cov pej xeem no paub tias muaj qhov xwm txheej siab ntawm AKI [24].

Cov ntaub ntawv thiab cov txheej txheem

Cov ntaub ntawv qhov chaw

Peb tau siv cov ntaub ntawv sau los ntawm cov neeg koom nrog Acute Respiratory Distress Syndrome (ARDS) Network Fluid and Catheter Treatment Trial (FACTT) los txheeb xyuas cov kev hloov pauv tshuaj uas yuav tshwm sim nrog kev siv keGFR hauv cov neeg mob hnyav [25,26]. Cov ntaub ntawv no tau tshaj tawm los ntawm National Heart, Lung and Blood Institute ntawm BioLINCC (https://biolincc.nhlbi.nih.gov/home/). FACTT yog ib qho kev sim, kev sim tshuaj ntsuam xyuas uas tau muab rau 1000 tus neeg koom nrog mob ntsws mob rau ob lub ntsws hlab ntsha catheter piv rau hauv nruab nrab venous catheter nrog rau cov kua dej liberal piv rau cov kua dej tswj kev tswj xyuas. Qhov kev sim sau txhua hnub SCr ze tshaj plaws rau 8 yog thiab qhov txiaj ntsig siab tshaj plaws txhua hnub rau thawj 7 hnub tom qab tso npe. Peb txwv qhov kev ntsuas ntawm kinetic kwv yees rau 8 teev sawv ntxov SCr qhov tseem ceeb. Yog tias 8 teev sawv ntxov SCr tus nqi ploj lawm (9 feem pua), tus nqi SCr siab tshaj plaws txhua hnub tau siv. SCR tau censored thaum pib lim ntshav. Cov neeg koom nrog tsawg kawg 2 SCr qhov tseem ceeb uas tseem tshuav tom qab censoring tau suav nrog hauv txoj kev tshawb no.

AKI txhais

AKI tau txhais los ntawm KDIGO qhov kev pom zoo txhais tau tias yog qhov nce ntxiv hauv 0.3mg/dL dhau ntawm 48- teev lub qhov rais lossis qhov txheeb ze nce hauv cov ntshav creatinine ntawm 50 feem pua ​​​​ntawm cov hauv paus lossis xav tau kev lim ntshav hauv 7 hnub ntawm kev tso npe kawm. Baseline SCr tau txhais tias yog tus nqi ze tshaj rau lub sijhawm ua ntej kev kawm randomization.

Kev tshuaj xyuas ntawm lub raum ua haujlwm thiab cov tshuaj noj tshuaj

Txhua hnub lub raum ua haujlwm tau pib txiav txim siab siv CG CrCl [27] lossis CKD-EPI eGFR [21] qhov sib npaug. CKD-EPI eGFRs tsis raug kho rau lub cev thaj tsam siv Mosteller formula- noj cov hauv paus square ntawm (qhov siab hauv cm * hnyav hauv kg / 3600) thiab faib tus nqi los ntawm 1.73m² [28,29] . Cov no tau muab piv rau kinetic versions ntawm cov kev kwv yees no suav nrog cov qauv tsim los ntawm Chen (Fig 1: Equation A) [9]. Qhov kev hloov pauv siab tshaj plaws hauv plasma creatinine yog raws li tus nqi ntawm creatinine tiam muab faib los ntawm qhov ntim ntawm kev faib tawm (Fig 1: Equation B). Tag nrho lub cev dej (TBW), siv los txiav txim qhov ntim ntawm kev faib tawm, tau txhais tias yog 0.6 * qhov hnyav hauv kilograms (kg).

Kev sib npaug A:

Kev sib npaug B:

Peb categorized tus qauv thiab kinetic kwv yees ntawmlub raum ua haujlwm as recommended by the FDA Guidance to Industry (>= 60, 30–59, 15–29 lossis < 15ml/min="" lossis="" ml/min/1.73m2="" )[23].="" qhov="" kev="" faib="" ua="" feem="" ntawm="" kev="" sib="" koom="" ua="" ke="" thiab="" qhov="" tsis="" sib="" xws="" ntawm="" pawg="" ua="" haujlwm="" ntawm="" tus="" qauv="" piv="" rau="" kev="" ntsuas="" kinetic="" tau="" suav="" rau="" cov="" neeg="" koom="" thiab="" rau="" cov="" hnub="" kawm="" ib="" leeg.="" peb="" suav="" hais="" tias="" cov="" neeg="" koom="" yuav="" tsum="" sib="" haum="" xeeb="" yog="" tias="" cov="" qauv="" thiab="" kinetic="" crcl="" lossis="" egfr="" pawg="" yog="" tib="" yam="" rau="" tag="" nrho="" 7="" hnub="" tom="" qab="" tso="" npe.="" cov="" neeg="" koom="" nrog="" raug="" suav="" hais="" tias="" tsis="" sib="" haum="" yog="" tias="" cov="" qauv="" thiab="" kinetic="" crcl="" lossis="" egfr="" pawg="" tsis="" zoo="" ib="" yam="" ntawm="" tsawg="" kawg="" yog="" ib="" qho="" ntawm="" 7="" hnub.="" rau="" cov="" neeg="" koom="" nrog="" pawg="" tshuaj="" noj="" tshuaj="" tsis="" sib="" haum,="" thawj="" qhov="" kev="" hloov="" pauv="" hauv="" qeb="" tau="" siv="" los="" ntsuas="" qhov="" cuam="" tshuam="" ntawm="" kev="" siv="" kinetic="" egfr="" lossis="" crcl="" sib="" npaug.="" 95="" feem="" pua="" ​​​​ntawm="" kev="" ntseeg="" siab="" rau="" cov="" feem="" pua="" ​​​​ntawm="" kev="" sib="" haum="" xeeb="" thiab="" kev="" tsis="" sib="" haum="" xeeb="" tau="" suav="" nrog="" siv="" cov="" kev="" faib="" tawm="" binomial.="" ib="" qho="" kev="" soj="" ntsuam="" rhiab="" heev="" kuj="" tau="" ua="" qhov="" twg="" cov="" neeg="" uas="" nws="" qhov="" kev="" kwv="" yees="" (tus="" qauv="" piv="" rau="" kinetic)="" tsawg="" dua="" 5ml="" min="" lossis="" 5ml="" min="" 1.73m2="" sib="" nrug="" tau="" suav="" nrog="" cov="" feem="" pua="" ​​​​ntawm="" cov="" uas="" tsis="" tas="" yuav="" tsum="" tau="" muab="" cais="">

Table 1. Cov yam ntxwv hauv paus ntawm tag nrho cov kev kawm FACTT tau suav nrog hauv kev tsom xam ntawm kinetic GFR thiab muab faib los ntawm qhov muaj thiab tsis muaj AKI.

Cov ntaub ntawv raug tso tawm raws li txhais tau tias ± SD, nruab nrab [IQR], thiab n (%).

Cov tshuaj kho kua dej kho

Vim tias qhov kev sim FACTT suav nrog cov tswv yim tswj cov kua dej, thiab cov kua dej ntau dhau tuaj yeem cuam tshuam rau kev paub tseeb ntawm cov ntshav creatinine thiab AKI [24], kev soj ntsuam theem nrab tau ua tiav siv cov kua-kho creatinine siv cov qauv piav qhia los ntawm Macedo li al [30]. Rau txhua hnub kawm, qhov sib npaug ntawm kev kawm cov kua dej sib npaug tau suav nrog siv 24- teev cov dej kom tsawg thiab tso tawm qhov twg Kho Cr=SCr *[1 ntxiv rau ntawm kev tshawb fawb net fluid balance/TBW]. Peb tau tshuaj xyuas qhov kev faib ua feem ntawm cov kev kawm uas yuav tsum tau muab tshuaj dua tshuaj hauv 4 pawg: cov neeg uas tsis muaj AKI ua ntej lossis tom qab hloov pauv cov kua dej, cov neeg uas muaj AKI tsuas yog tom qab hloov cov kua dej, cov uas muaj AKI ua ntej tab sis tsis tom qab hloov cov kua dej. , thiab cov neeg uas muaj AKI ob qho tib si ua ntej thiab tom qab hloov kho cov kua dej, raws li tau piav qhia dhau los.

Kev txheeb cais

Qhov sib txawv ntawm cov ntsiab lus tau muab piv nrog kev txheeb xyuas qhov sib txawv (ANOVA) thaum qhov sib txawv ntawm qhov sib txawv tau muab piv nrog kev xeem Kruskal-Wallis. Qhov sib txawv ntawm qhov sib piv tau ua los ntawm Pearson's chi-squared test. Kev txheeb xyuas cov ntaub ntawv tau ua los ntawm Stata 15.1 (StataCorp, College Station, TX). P tus nqi < 0.05="" tau="" suav="" tias="" yog="" qhov="" tseem="">

cistanche tuaj yeem tonify raum

Cov txiaj ntsig

Tag nrho ntawm 54 tus neeg koom nrog FACTT raug tshem tawm vim yog qhov yuav tsum tau lim ntshav lossis tuag hauv hnub 1 ntawm kev nrhiav neeg ua haujlwm [N=28] lossis cov ntaub ntawv ploj lawm uas tsis tso cai rau kev kwv yees kwv yees [N=26]. Cov pej xeem zaum kawg yog tsim los ntawm 946 tus neeg koom, nrog cov yam ntxwv hauv paus raws li qhia hauv Table 1. 496 (52 feem pua) tsim AKI hauv 7 hnub ntawm kev tso npe. Ib qho ntxiv 110 tus neeg koom tsim AKI tom qab hauv txoj kev tshawb no tab sis tsis suav tias muaj AKI rau qhov kev tshuaj ntsuam no. Hnub nyoog, poj niam txiv neej, thiab qhov hnyav tau zoo ib yam ntawm cov uas muaj thiab tsis muaj AKI. Txawm li cas los xij, muaj ntau tus neeg Asmeskas Asmeskas uas muaj AKI. Cov neeg mob uas tsim AKI kuj tseem yuav muaj ntshav qab zib, kub siab, thiab muaj creatinine siab dua ntawm qhov pib. Thaum lub sijhawm nrhiav neeg ua haujlwm, lawv kuj tseem yuav muaj mob hnyav dua, nrog rau kev siv vasopressor ntau dua thiab siab dua physiology thiab kev ntsuas kev noj qab haus huv III (APACHE III) cov qhab nia. Hauv thawj qhov kev tshuaj xyuas (qhov uas tsis muaj kev hloov kho rau qhov sib txawv ntawm cov kua dej sib npaug ntawm cov caj npab kho), cov neeg koom nrog AKI muaj feem tsawg dua cov uas tsis muaj AKI yuav tsum tau randomized rau cov kua dej liberal caj npab (45 vs 54 feem pua, p.<0.01), similar="" to="" prior="" work="" [24,31].="" those="" with="" aki="" had="" fewer="" ventilator-free="" days="" (median="" 10="" vs="" 21,="" p="" <="" 0.01)="" and="" higher="" 60-day="" mortality="" (16%="" vs="" 34%,="" p="" <="" 0.01).="">

Peb tom ntej no piv cov tshuaj CrCl lossis eGFR pawg (*60, 30–59, 15–29, thiab<15ml min)="" using="" standard="" and="" kinetic="" estimates.="" fig="" 2="" illustrates="" crcl="" over="" time="" in="" a="" subject="" who="" had="" to="" worsen="" aki="" followed="" by="">lub raum rov qab.Hauv cov ntsiab lus no, kinetic kwv yees qis dua li CrCl hauv kev teeb tsa ntawm AKI thiab ua rau tsis zoolub raum ua haujlwm, qhov kev kwv yees kinetic tau siab dua CrCl thaum rov qab los.

Thaum kev kwv yees kwv yees piv rau cov qauv kwv yees, 19.3 feem pua ​​[95 feem pua ​​CI 16.8 feem pua ​​– 21.9 feem pua] ntawm cov neeg koom thiab 23.4 feem pua ​​[95 feem pua ​​CI 20.7 feem pua ​​– 26.1 feem pua] yuav tsum tau muaj kev hloov nyob rau hauv cov tshuaj qeb ntawm tsawg kawg yog ib hnub kawm siv CG CrCl thiab tsis kho rau BSA CKD-EPI sib npaug, raws li (Table 2). Cov neeg uas muaj AKI feem ntau yuav muaj cov qauv tsis sib haum xeeb thiab kev siv tshuaj kinetic. Piv txwv li, thaum siv CG CrCl, 33.5 feem pua ​​[95 feem pua ​​CI 29.3 feem pua ​​- 37.6 feem pua] ntawm cov uas muaj AKI piv rau 3.8 feem pua ​​[95 feem pua ​​CI 2.0 feem pua ​​-5.5 feem pua] ntawm cov uas tsis muaj AKI yuav tsum muaj AKI. feem ntau yuav tsum tau hloov kho thaum lub sij hawm poob hauv cov ntshav Cr uas yuav sawv cev rov qab los ntawm AKI. Hauv kev tshuaj ntsuam rhiab heev, peb tshem tawm cov kev hloov me me (< 5ml/min="" between="" kinetic="" and="" non-kinetic="" estimates)="" from="" the="" recategorization="" analysis.="" for="" example,="" in="" the="" sensitivity="" analysis,="" if="" the="" crcl="" was="" 32ml/min="" and="" the="" kinetic="" crcl="" was="" 28ml/min,="" the="" participant="" was="" not="" considered="" to="" have="" a="" change="" in="" the="" medication="" dosing="" category="" for="" that="" day.="" there="" was="" a="" smaller="" proportion="" of="" individuals="" with="" discordant="" dosing="" categories="" (13.6%="" for="" cg="" cl,="" [95%="" ci="" 11.4%-15.8%];="" 16.0%="" [95%="" ci="" 13.7–18.4%]="" for="" ckd-epi="" egfr,="" s1="" table)="" but="" the="" proportion="" was="" still="">

kinetic kwv yees. Kab rov tav kab hauv daim duab demarcate FDA dosing pawg (piv txwv li, 15, 30, thiab 60mL / min). Tom qab cov creatinine nce sai thaum lub sij hawm kev loj hlob ntawm AKI hnyav, kinetic CG CrCl poob rau hauv 15-30mL / min dosing qeb nyob rau hnub 1, thaum CG CrCl koob tshuaj qeb yog 30-60mL / min. Cov ncauj lus no yuav raug suav hais tias muaj kev sib cais ntawm cov tshuaj noj tshuaj nyob rau hnub no. Hloov pauv, Hnub 7, qhov kev kwv yees kinetic siab dua li CG CrCl vim tias qhov poob ntawm SCr poob thaum lub raum rov qab. Siv qhov sib npaug ntawm CKD-EPI, pawg tshuaj noj tshuaj tsis sib haum tsuas yog tshwm sim rau Hnub 1. Nyob rau lwm hnub kawm, pawg tshuaj noj tshuaj muaj kev sib raug zoo.

Table 2. Dosing recategorization using kinetic estimates of CrCl and eGFR. The percentage of patients who required recategorization with the use of kinetic estimates of each formula is shown, stratified by AKI status. The number of drug dosing categories crossed (>60, 30–60, 15–29, < 15ml / min) yog hais txog hnub kawm thawj zaug uas yuav tsum tau rov kho dua.

Rau cov neeg koom nrog, kev siv cov kev kwv yees kwv yees tsuas yog cuam tshuam rau kev siv tshuaj yeeb hauv ib hnub ntawm kev kawm. Raws li tau piav qhia los ntawm cov ntaub ntawv los ntawm ib tus neeg koom nrog kev kawm nrog AKI hauv daim duab 2, kinetic kwv yees yuav tau hloov cov kev coj noj coj ua txhua hnub ntawm 3 ntawm 7 hnub kawm (Hnub 1, 3, thiab 7). Thaum peb tshuaj xyuas ib hnub rau tag nrho cov neeg kawm (Table 3), kev noj tshuaj tsis sib haum tau pom nyob rau hauv 4.6 feem pua ​​​​ntawm tag nrho cov hnub siv CG CrCl thiab 6.0 feem pua ​​​​ntawm tag nrho cov hnub siv CKD-EPI kab zauv (S2 Table ). Txawm hais tias AKI cov xwm txheej, kev sib haum xeeb ntawm CG CrCl thiab kinetic GFR kwv yees cov tshuaj txo qis nrog GFR qis. Hauv cov neeg uas muaj AKI, kev siv tshuaj tsis sib haum xeeb tau nce mus rau 8.5 feem pua ​​​​ntawm tag nrho cov hnub siv CG CrCl kab zauv thiab 10.2 feem pua ​​​​ntawm tag nrho cov hnub siv qhov sib npaug CKD-EPI. Kev tsis sib haum xeeb tshwm sim thaum lub sij hawm tsim ntawm AKI thiab rov qab los. Qhov tsis sib xws tau tshwm sim feem ntau tam sim tom qab kev kawm cuv npe thiab tsis kam dhau sijhawm (S3 Table). Kev poob qis hauv kev tsis sib haum xeeb yog qhov tseem ceeb dua thaum CG CrCl raug siv piv rau CKD-EPI kab zauv.

Raws li kev txheeb xyuas qhov kev xav tau zaum kawg, vim tias qhov kev sim FACTT koom nrog cov tswv yim tswj cov kua dej tshwj xeeb, kev tshuaj xyuas tau rov qab siv cov kua kho SCr raws li tau piav qhia hauv Macedo li al (S4 Table) [30]. 3 cov ntsiab lus raug tshem tawm vim lawv tsuas muaj 1 hnub ntawm cov ntaub ntawv dej. Nrog rau kev kho cov kua dej, qhov kev faib ua feem ntawm cov kev kawm uas yuav tsum tau siv tshuaj kho dua tshiab tau nce tag nrho (los ntawm 19.4 feem pua ​​​​mus rau 23.4 feem pua ​​​​ntawm kev siv CG CrCl equation thiab los ntawm 23.4 feem pua ​​​​mus rau 25.2 feem pua ​​​​ntawm kev siv CKD-EPI kab zauv). Recategorization tshwm sim tsawg kawg hauv cov neeg uas tsis tau raws li AKI txhais tau tias siv cov dej tsis raug kho lossis cov kua dej kho creatinine qhov tseem ceeb (3.2 feem pua ​​​​ntawm cov kev sib npaug CG CrCl thiab 3.9 feem pua ​​​​ntawm cov kev sib npaug CKD-EPI) thiab feem ntau ntawm cov neeg uas tau ntsib AKI cov ntsiab lus siv. ob qho tib si tsis-kua kho thiab kho cov kua dej (44.0 feem pua ​​​​ntawm kev siv CG CrCl kab zauv thiab 44.2 feem pua ​​​​ntawm kev siv CKD-EPI kab zauv).

Table 3. Kev muab tshuaj rov ua dua los ntawm hnub kawm. Kev sib piv ntawm cov koob tshuaj rau txhua hnub kawm siv lub kinetic piv rau tus qauv Cockcroft Gault CrCl hauv txhua yam kev kawm thiab muab faib los ntawm AKI raws li txoj cai. Cov ntsiab lus raws kab kab pheeb ces kaum muaj qhov sib txuam tshuaj siv ob qhov kev kwv yees, hos cov nyob hauv cov kab pheeb ces kaum muaj cov tshuaj tsis sib xws uas siv ob qhov kev kwv yees. Feem ntau ntawm cov tshuaj redosing tshwm sim hauv cov kev kawm uas tau ntsib AKI.

Kev sib tham

Tam sim no, tsis muaj txoj hauv kev los tshuaj xyuas cov tshuaj hauv AKI tau hloov pauvlub raum ua haujlwmthiab pom cov cim xws li SCr. Qhov no yog teeb meem thaum lub sij hawm kev loj hlob ntawm AKI thaum CrCl los yog eGFR yuav overestimate lub raum kev ua hauj lwm thiab tej zaum yuav ua rau cov tshuaj tsub zuj zuj thiab muaj peev xwm toxicity nrog rau lub raum rov qab thaum CrCl los yog eGFR yuav underestimate lub raum ua hauj lwm thiab cov tshuaj kho mob tej zaum yuav tsis tau. Muaj kev nthuav dav hauv kev siv cov kinetic sib npaug los kho cov kwv yees ntawm lub raum ua haujlwm. Ntawm no, peb qhia hauv cov neeg mob hnyav ntawm cov neeg mob nrog ARDS tias kev siv Chen kinetic kwv yees sib npaug yuav cuam tshuam rau kev noj tshuaj hauv ib feem peb ntawm cov neeg mob hnyav. Ntawm cov neeg uas muaj AKI, kev siv tshuaj yuav raug cuam tshuam rau 33.5 feem pua ​​​​thiab 37.9 feem pua ​​​​ntawm cov neeg mob siv CrCl sib npaug thiab CKD-EPI sib npaug, feem.

Tsis tas li ntawd, peb pom tias qhov sib npaug kinetic cuam tshuam rau kev siv tshuaj ntau tshaj ntawm eGFRs qis. Qhov no yuav yog vim qhov qis qis ntawm lub raum ua haujlwm, kev hloov kho 50mL / min (piv txwv li los ntawm 60 txog 10mL / min) los ntawm kev sib npaug kinetic ua rau muaj kev hloov pauv ntawm ob pawg tshuaj. Hauv qhov sib piv, ntawm qib siab ntawm lub raum ua haujlwm, kev hloov kho zoo sib xws (piv txwv li los ntawm 120 txog 70mL / min) yuav tsis tas yuav siv tshuaj kho dua tshiab. Qhov cuam tshuam ntawm kinetic equations kuj tseem ceeb tshaj plaws nyob rau hauv thawj ob peb hnub ntawm tsev kho mob thiab wanes lub sij hawm, tshwj xeeb tshaj yog thaum kinetic CrCl tau siv ntau dua li qhov sib npaug ntawm kinetic CKD-EPI. Peb xav tias qhov sib txawv ntawm qhov sib npaug ntawm ob lub sijhawm dhau los yog qhov thib ob kom txo qis cov ntshav creatinine qhov tseem ceeb tau pom thaum lub raum rov qab los tom tsev kho mob. Kev lig kev cai, CG CrCl sib npaug ua rau muaj kev kwv yees ntau dualub raum ua haujlwmpiv rau CKD-EPI qhov sib npaug ntawm cov nqi qis ntawm cov ntshav creatinine, thiab, raws li tau piav qhia saum toj no, nyob rau theem siab ntawm kev kwv yees lub raum ua haujlwm, kev hloov kho kinetic tsis tshua muaj feem cuam tshuam rau kev hloov pauv ntawm cov tshuaj noj tshuaj.

Ob peb xyoos dhau los, Chen's kinetic equation tau nce siv thiab siv tau hauv ntau qhov chaw. Hauv qhov chaw saib xyuas mob hnyav, keGFR ua tau zoo dua li ob peb yam tshiab biomarkers hauv kev kwv yeeslub raum rov qabthiab qhov tsis zoo lojraumxwm txheej [11]. KeGFR kuj tau sim hauv cov neeg mob uas tau phais mob plawv rau kev kwv yees AKI thiab kev ua haujlwm tuag [14]. Qhov sib npaug kuj tau siv rau hauv cov neeg hloov lub raum txhawm rau txhim kho kev tshawb pom AKI thaum ntxov hauv cov neeg pub dawb [32], los kwv yees ncua kev ua haujlwm graft hauv cov neeg tau txais lub raum hloov [10,13] thiab ua qhov kawg thib ob rau kev sim tshuaj ntsuam xyuas qhov twg cov randomized. rau cov kua ntsev sib npaug (Plasma-Lyte) piv rau cov kua qaub ib txwm ua rau zoo dua keGFR [33]. Ua ke, cov kev tshawb fawb no qhia tias keGFR txhim kho kev kwv yees thiab kev nkag siab ntawm lub raum ua haujlwm hauv AKI thaum cov ntshav creatinine hloov pauv sai. Txawm li cas los xij, muaj qee qhov kev tshawb fawb ntsuas keGFR rau lub hom phiaj ntawm kev siv tshuaj[19,20]. Harada [19] et al. piv nrog ntsuas vancomycin concentrations nrog kev kwv yees vancomycin concentrations tau muab los ntawm kev kwv yees sib txawv ntawm lub raum ua haujlwm, tab sis qhov kwv yees concentration [34] tau muab los ntawm CG CrCl, uas yuav cuam tshuam cov txiaj ntsig ntawm CG sib npaug. Cov kws kho mob-coj tshuaj noj tshuaj feem ntau siv CG CrCl vim tias yav dhau los US Food and Drug Administration tau qhia txog cov tshuaj pharmacokinetic raws li CrCl. Hauv qhov sib piv, nephrologists feem ntau siv eGFR kwv yees rau kev siv tshuaj hauv CKD, uas yuav ua rau muaj kev pom zoo tsis sib xws [35,36].

cistanche tuaj yeem txhim kho lub raum ua haujlwm

Hauv AKI, qhov kev kwv yees tsis tu ncua hauv xeev ua haujlwm tsis zoo. Hauv kev tshawb fawb los ntawm Bragadottir et al. [37], qhov yuam kev hauv pawg yog 68.7 feem pua ​​, 67.7 feem pua ​​, thiab 68.0 feem pua ​​​​rau MDRD eGFR, CKD-EPI eGFR, thiab CG CrCl raws li piv rau qhov ntsuas GFR ( ntsuas los ntawm 51Cr-EDTA) thaum ntxov AKI. Kev sib npaug uas suav rau SCr kinetics tuaj yeem txhim kho qhov kev ntsuas ntawm lub raum ua haujlwm hauv AKI. Jelliffe mis, ib qho ntawm thawj kinetic GFR sib npaug, tau pom tias zoo tshaj rau kev kwv yees sib npaug hauv cov kev tshawb fawb me me [6,38]. Hauv AKI, eGFR los ntawm CG CrCl, MDRD eGFR, thiab Jelliffe cov qauv qhia overestimated urinary creatinine clearance 80 feem pua, 33 feem pua, thiab 10 feem pua ​​ntawm lub sij hawm feem [38]. Txawm hais tias tus qauv Chen tsis tau sim, cov txiaj ntsig no qhia tau tias cov kev sib tw kinetic tuaj yeem txhim kho qhov kev ntsuas ntawmlub raum ua haujlwmhauv AKI. Piv nrog rau cov qauv ua ntej, cov qauv Chen muab kev yooj yim algebraic uas tso cai rau kev siv yooj yim rau hauv kev kho mob.

Peb txoj kev tshawb nrhiav nrhiav los txiav txim siab txog qhov cuam tshuam ntawm keGFR ntawm kev siv tshuaj yog tias keGFR tau siv dav rau hauv cov ntaub ntawv kho mob hauv hluav taws xob, tshem tawm qhov xav tau rau kev ntsuas kev ntsuas zis ntau dhau sijhawm. Txawm hais tias kev saib xyuas cov tshuaj kho mob tuaj yeem siv rau qee yam tshuaj (xws li vancomycin), muaj qee cov tshuaj uas muaj peev xwm saib xyuas lub sijhawm tiag tiag. Feem ntau siv, cov tshuaj tseem ceeb hauv cov neeg mob hnyav feem ntau yuav tsum tau rov kho dua raws li GFR qeb. Piv txwv li, cov koob tshuaj kho mob rau cefepime txawv ntawm 2 g txhua 8 teev nyob rau hauv qhov chaw ntawm lub raum ua haujlwm mus rau 1 g intravenous txhua 24 teev nyob rau hauv qhov chaw ntawm GFR <10 ml="" min="" rau="" cov="" kab="" mob="" pseudomonal.="" cefepime="" tsub="" zuj="" zuj="" tuaj="" yeem="" ua="" rau="" encephalopathy="" thiab="" coma,="" tab="" sis="" kev="" siv="" tshuaj="" tsis="" txaus="" tuaj="" yeem="" ua="" rau="" kev="" kho="" mob="" tsis="" txaus.="" kev="" koom="" ua="" ke="" ntawm="" kegfr="" rau="" hauv="" cov="" ntaub="" ntawv="" kho="" mob="" hauv="" hluav="" taws="" xob="" tuaj="" yeem="" pab="" cov="" kws="" kho="" mob="" yooj="" yim="" kho="" cov="" tshuaj="" cefepime="" txhua="" hnub="" kom="" tsis="" txhob="" muaj="" tshuaj="" lom="" nyob="" rau="" hauv="" qhov="" teeb="" meem="" ntawm="" aki="" hnyav="" zuj="" zus="" thiab,="" ib="" yam="" li="" qhov="" tseem="" ceeb,="" tsis="" txhob="" noj="" qis="" thaum="" lub="" sij="">lub raum rov qab. Cov txheej txheem yav tom ntej kuj tseem yuav suav nrog kev siv cov tshuaj pom tshiab biomarkers xws li cystatin C thiab kev ntsuas GFR ntawm lub sijhawm, uas yuav muaj sai sai los ntsuas cov tshuaj tshem tawm hauv AKI. Txawm li cas los xij, nws tsis zoo li qhov kev ntsuas GFR lub sijhawm tiag tiag yuav siv tau rau txhua tus neeg mob thoob plaws txhua qhov chaw. Yog li, kev tshawb fawb ntxiv yog tsim nyog los sib piv keGFR nrog ntsuas GFR kom tso cai rau tus nqi-zoo thiab muaj txiaj ntsig ntawm kev kwv yees GFR hauv AKI.

Lub zog ntawm txoj kev tshawb no suav nrog kev siv ntau haiv neeg, cov neeg mob hnyav nrog cov ntaub ntawv creatinine txhua hnub. Peb xaiv hom tshuaj noj uas loj thiab muaj txiaj ntsig zoo. Yog li ntawd, cov txiaj ntsig yuav tsum muaj zog heev rau cov kev hloov me me hauv eGFR. Tsis tas li ntawd, muaj tsawg cov ntaub ntawv ploj lawm. Nyob rau hauv cov rooj plaub uas cov neeg mob tau raug tshem tawm vim qhov kev kwv yees kinetic tsis muaj nyob rau theem nrab ntawm kev tuag / kev lim ntshav thaum ntxov, nws tau xav tias yog tias kinetic GFR tau siv rau hnub tom qab, qhov feem pua ​​​​ntawm cov neeg koom uas xav tau kev hloov kho nrog kev siv keGFR yuav nce ntxiv. Yog li, qhov kev tshawb fawb no muab kev kwv yees kwv yees ntawm cov neeg uas yuav raug cuam tshuam.

Txoj kev tshawb no muaj qee qhov kev txwv. Ua ntej, thaum peb ntsuas qhov feem pua ​​​​ntawm cov neeg koom thiab hnub uas xav tau kev hloov pauv ntawm kev siv tshuaj, peb tsis muaj tshuaj lom lossis qib muaj; Qhov tseeb, qib tshuaj tsis tshua muaj los qhia kev noj tshuaj. Yog li ntawd, peb tsis tuaj yeem txheeb xyuas seb puas siv tshuaj kho dua tshiab uas siv cov qauv kinetic no yuav cuam tshuam ncaj qha rau cov neeg koom nrog. Kev tuag ntau dua tau pom nyob rau hauv cov neeg uas xav tau tshuaj kho dua tshiab, tab sis qhov no yuav yog vim qhov mob hnyav ntawm AKI es tsis yog tshuaj toxicity lossis tshuaj subtherapeutic.

Cov lus xaus

Hauv cov neeg mob hnyav heev nrog ARDS thiab tag nrho AKI tus nqi ntawm 52 feem pua, kev siv cov kwv yees kwv yees ntawmlub raum ua haujlwmyuav muaj feem cuam tshuam txog kev noj tshuaj hauv ib lub hlis twg ntawm txhua qhov kev kawm thaum thawj lub lim tiam ntawm kev nkag. Feem ntau ntawm cov tshuaj redosing no yuav tshwm sim hauv cov neeg koom nrog AKI, thiab hauv qhov kev tshuaj ntsuam no, kwv yees li 8-10 feem pua ​​​​ntawm cov hnub kawm ntawm cov neeg uas muaj AKI yuav raug cuam tshuam. Yog li, qhov loj ntawm cov tshuaj redosing uas yuav tshwm sim nyob rau hauv cov neeg mob hnyav nrog kev siv keGFR tau lees paub cov kev tshawb fawb ntxiv los ntsuas qhov kev siv tshuaj kho mob ntawm keGFR.

Txhawb cov ntaub ntawv

S1 Tab. Kev soj ntsuam rhiab heev tshem tawm cov kev hloov pauv hauv pawg koob tshuaj vim qhov sib txawv ntawm tsawg dua 5 mL / min ntawm tus qauv thiab kev kwv yees kinetic. (DOCX)

S2 Tab. Dosing qeb hloov pauv siv tus qauv thiab kinetic CKD-EPI eGFR. (DOCX)

S3 Tab. Kev tsis sib haum xeeb ntawm cov tshuaj hauv ob qho tib si sib npaug thoob plaws hnub kawm. (DOCX)

S4 Tab. Kev tshuaj ntsuam xyuas cov kua dej ntawm tus qauv piv rau lub raum ua haujlwm kinetic. (DOCX)

Kev lees paub

Peb xav lees paub qhov kev koom tes ntawm FACTT cov neeg koom nrog uas tau pab cov ntaub ntawv rau peb qhov kev tshuaj xyuas.

Sau Kev Pab Txhawb

Conceptualization: Yuenting D. Kwong, Kathleen D. Liu. Cov ntaub ntawv curation: Yuenting D. Kwong, Kathleen D. Liu. Kev txheeb xyuas raug cai: Yuenting D. Kwong

Kev Tshawb Fawb: Yuenting D. Kwong.

Methodology: Yuenting D. Kwong, Sheldon Chen, Rima Bouajram, Fanny Li, Kala M. Mehta, David V. Glidden, Kathleen D. Liu.

Saib xyuas: Kathleen D. Liu. Visualization: Rima Bouajram.

Sau – original draft: Yuenting D. Kwong.

Sau – tshuaj xyuas & kho: Yuenting D. Kwong, Sheldon Chen, Rima Bouajram, Fanny Li, Michael A. Matthay, Kala M. Mehta, David V. Glidden, Kathleen D. Liu.

cistanche rau lub raum

Cov ntaub ntawv

1. Uchino S, Kellum JA, Bellomo R, Doig GS, Morimatsu H, Morgera S, et al. Mob raum tsis ua hauj lwm nyob rau hauv cov neeg mob hnyav: ib tug multinational, multicenter kawm. JAMA. 2005; 294: 813–818 : kuv.

2. Mehta RL, Pascual MT, Soroko S, Savage BR, Himmelfarb J, Ikizler TA, et al. Spectrum ntawm lub raum tsis ua haujlwm hauv chav saib xyuas mob hnyav: PICARD kev paub. Raum Int. 2004; 66: 1613–1621.

3. Chertow GM, Burdick E, Honour M, Bonventre JV, Bates DW. Mob raum raug mob, kev tuag, kev nyob ntev, thiab cov nqi hauv tsev kho mob cov neeg mob. J Am Soc Nephrol. 2005; 16: 3365–3370.

4. Mark Moran S, Myers BD. Cov kev mob raum tsis ua haujlwm tau kawm los ntawm tus qauv ntawm creatinine kinetics. Lub raum International. Xyoo 1985; 27: 928–937.

5. Chiou WL, Hsu FH. Ib txoj hauv kev yooj yim thiab ceev ceev tshiab los saib xyuas lub raum ua haujlwm raws li kev tshuaj xyuas pharmacokinetic ntawm endogeneous creatinine =. Res Commun Chem Pathol Pharmacol. Xyoo 1975; 10: 315–330. PIB: 115383999

6. Jelliffe R. Kev kwv yees ntawm creatinine tshem tawm hauv cov neeg mob uas lub raum tsis ua haujlwm, tsis muaj cov zis tso zis. Yog J Nephrol. 2002; 22: 320–324.

7. Jelliffe RW, Jelliffe SM. Ib qho khoos phis tawj rau kev kwv yees ntawm creatinine tshem tawm los ntawm cov ntshav creatinine tsis ruaj khov, hnub nyoog, poj niam txiv neej, thiab qhov hnyav. Mathematical Biosciences. Xyoo 1972; 14:17–24.

8. Yashiro M, Ochiai M, Fujisawa N, Kadoya Y, Kamata T. Kev ntsuam xyuas ntawm kwv yees li creatinine tshem tawm ua ntej nyob ruaj khov hauv lub raum raug mob los ntawm creatinine kinetics. Clin Exp Nephrol. 2012; 16: 570–579.

9. Chen S. Retooling lub Creatinine Clearance Equation los kwv yees Kinetic GFR thaum lub Plasma Creatinine hloov zuj zus. JASON. 2013; 24: 877–888.

10. Pianta TJ, Endre ZH, Pickering JW, Buckley NA, Peake PW. Kev kwv yees Kinetic ntawm GFR txhim kho kev kwv yees ntawm Dialysis thiab rov qab los tom qab hloov raum. PLOS IB. 2015; 10: e0125669.

11. Dewitte A, Joannès-Boyau O, Sidobre C, Fleureau C, Bats ML, Derache P, et al. Kinetic eGFR thiab Novel AKI Biomarkers los kwv yees lub raum rov qab. Clin J Am Soc Nephrol. 2015; 10: 1900–1910.

12. O'Sullivan ED, Doyle A. Qhov chaw kho mob ntawm kinetic glomerular filtration rate. Clin raum J. 2017; 10: 202–208.

13. Endre ZH, Pianta TJ, Pickering JW. Kev kuaj mob raws sij hawm ntawm mob raum raug mob siv Kinetic eGFR thiab Creatinine Excretion rau Ntau Lawm, E / eG-Creatinine tuaj yeem pab tau! Nephron. 2016; 132: 312–316.

14. Seelhammer TG, Maile MD, Heung M, Haft JW, Jewell ES, Engoren M. Kinetic kwv yees glomerular filtration rate thiab mob raum raug mob hauv cov neeg mob phais plawv. J Crit Care. 2016; 31: 249–254.

15. de Oliveira Marques F, Oliveira SA, de Lima E Souza PF, Nojoza WG, da Silva Sena M, Ferreira TM, et al. Kinetic kwv yees glomerular filtration rate nyob rau hauv cov neeg mob hnyav: dhau ntawm lub raum raug mob hnyav rau kev faib tawm. Crit Care. 2017; 21:280 : kuv.

16. Pickkers P, Ostermann M, Joannidis M, Zarbock A, Hoste E, Bellomo R, et al. Cov txheej txheem kho mob hnyav rau mob raum raug mob. Intensive Care Med. 2017; 43: 1198–1209. PMID: 28138736 17. Chawla LS, Bellomo R, Bihorac A, Goldstein SL, Siew ED, Bagshaw SM, et al. Mob raum mob thiab lub raum rov qab: daim ntawv tshaj tawm pom zoo ntawm Cov Kab Mob Zoo Tshaj Plaws (ADQI) 16 Workgroup. Nat Rev Nephrol. 2017; 13:241–257. PIB: 28239173

18. Chen S. Kinetic Glomerular filtration Rate nyob rau hauv niaj hnub Clinical Practice-Applications thiab possibilities. Adv Chronic Kidney Dis. 2018; 25:105–114.

19. Harada D, Uchino S, Kawakubo T, Takinami M. Predictability ntawm serum vancomycin concentrations siv lub kinetic kwv yees glomerular filtration rate formula rau cov neeg mob hnyav. Int J Clin Pharmacol Ther. 2018; 56: 612–616.

20. Carrie´ C, Rubin S, Sioniac P, Breilh D, Biais M. Lub kinetic glomerular filtration rate tsis hloov pauv nrog kev ntsuas creatinine clearance rau kev kwv yees ntawm piperacillin underexposure nyob rau hauv cov neeg mob hnyav nrog augmented raum clearance. Kev kho mob tseem ceeb. 2018; 22:177 : kuv.

21. Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF, Feldman HI, et al. Ib qho kev sib npaug tshiab los kwv yees glomerular filtration rate. Ann Intern Med. 2009; 150: 604–612.

22. Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. Ib txoj hauv kev zoo dua los kwv yees glomerular filtration rate los ntawm serum creatinine: ib qho kev kwv yees tshiab. Kev hloov pauv kev noj zaub mov hauv Pab Pawg Saib Xyuas Kab Mob Raum. Ann Intern Med. Xyoo 1999; 130: 461–470. PIB: 100756133

23. US Department of Health thiab Human Services. Kev taw qhia rau kev lag luam: Pharmacokinetics nyob rau hauv cov neeg mob uas muaj lub raum tsis ua hauj lwm-Study Design, Data Analysis, thiab cuam tshuam rau Dosing thiab Labeling. Food and Drug Administration. Center for Drug Evaluation and Research; 2010. Muaj

24. Liu KD, Thompson BT, Ancukiewicz M, Steingrub JS, Douglas IS, Matthay MA, et al. Mob raum raug mob hauv cov neeg mob uas mob ntsws mob hnyav: Kev cuam tshuam ntawm cov kua dej sib xyaw ntawm kev faib cov mob raum mob thiab cov txiaj ntsig sib txuas. Crit Care Med. 2011; 39: 2665–2671. PIB: 21785346

25. National Heart Lung, Network BIARDS (ARDS) CT. Kev sib piv ntawm Ob Lub Tswv Yim Tswj Kev Tswj Dej hauv Kev Mob Nkeeg Mob. New England Journal of Medicine. 2006; 354: 2564–2575. PIB: 16714767

26. National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network, Wheeler AP, Bernard GR, Thompson BT, Schoenfeld D, Wiedemann HP, et al. Pulmonaryartery piv rau central venous catheter los qhia kev kho mob ntsws mob. N Engl J Med. 2006; 354: 2213–2224. PIB: 16714768

27. Cockcroft DW, Gault MH. Kev kwv yees ntawm creatinine tshem tawm los ntawm cov ntshav creatinine. Nephron. Xyoo 1976; 16:31–41. PIB: 12445644

28. Stevens LA, Nolin TD, Richardson MM, Feldman HI, Lewis JB, Rodby R, et al. Kev sib piv ntawm cov lus pom zoo noj tshuaj raws li ntsuas GFR thiab lub raum kev ua haujlwm kwv yees sib npaug. Am J Raum Dis. 2009; 54:33–42. PIB: 19446939

29. Jones GR. Kev kwv yees lub raum muaj nuj nqi rau kev txiav txim siab noj tshuaj. Clin Biochem Rev. 2011; 32:81–88. PIB: 21611081

30. Macedo E, Bouchard J, Soroko SH, Chertow GM, Himmelfarb J, Ikizler TA, et al. Kev tsim cov kua dej, kev paub thiab kev ua haujlwm ntawm lub raum raug mob hauv cov neeg mob hnyav. Crit Care. 2010; 14: r82.

31. Grissom CK, Hirshberg EL, Dickerson JB, Brown SM, Lanspa MJ, Liu KD, et al. Kev tswj cov kua dej nrog cov txheej txheem kev saib xyuas yooj yim rau tus mob ua pa nyuaj *. Crit Care Med. 2015; 43: 288–295. PIB: 25599463

32. Hekmat R, Eshraghi H, Esmailpour M, Hassankhani GG. Kinetic Glomerular filtration tus nqi kwv yees piv nrog rau lwm cov qauv rau kev ntsuam xyuas mob raum mob theem ntxov tom qab pub raum. Exp Clin Hloov. 2017; 15:104–109. PIB: 28260446

33. Weinberg L, Harris L, Bellomo R, Merino FL, Story D, Eastwood G, et al. Cov teebmeem ntawm kev ua haujlwm tsis zoo thiab thaum ntxov postoperative ib txwm saline lossis Plasma-Lyte 148® ntawm hyperkalemia hauv kev hloov pauv lub raum tuag: kev sim ob qhov muag tsis pom kev randomized. British Journal of Anaesthesia. 2017; 119: 606–615.

34. Yasuhara M, Iga T, Zenda H, Okumura K, Oguma T, Yano Y, et al. Cov pej xeem pharmacokinetics ntawm vancomycin hauv cov neeg laus neeg Nyij Pooj. Ther Drug Monit. Xyoo 1998; 20: 139–148. PMID: 9558127 35. Gill J, Malyuk R, Djurdjev O, Levin A. Siv cov kev sib npaug ntawm GFR los kho cov tshuaj nyob rau hauv ib pawg neeg laus ntau haiv neeg—cov lus ceeb toom. Nephrol Dial Hloov. 2007; 22: 2894–2899 : kuv. PIB: 17575316

36. Golik MV, Lawrence KR. Kev sib piv ntawm cov lus pom zoo rau kev siv tshuaj tua kab mob raws li ob txoj hauv kev los ntsuas lub raum kev ua haujlwm: Cockcroft-gault thiab kev hloov pauv kev noj zaub mov hauv lub raum kab mob. Pharmacotherapy. 2008; 28: 1125–1132.

37. Bragadottir G, Redfors B, Ricksten SE. Kev ntsuam xyuas glomerular filtration rate (GFR) hauv cov neeg mob hnyav nrog rau mob raum raug mob - muaj tseeb GFR piv rau urinary creatinine clearance thiab kwv yees qhov sib npaug. Crit Care. 2013; 17: r108.

38. Bouchard J, Macedo E, Soroko S, Chertow GM, Himmelfarb J, Ikizler TA, et al. Kev sib piv ntawm txoj kev kwv yees glomerular filtration rate nyob rau hauv cov neeg mob hnyav nrog mob raum raug mob. Nephrol Dial Hloov. 2010; 25:102–107.