Augmented renal clearance in the intensive care units: concepts to considerate in drug dosing

Augmented renal clearance (ARC) is a manifestation of renal function that can be seen in patients admitted to the Intensive Care Unit. Its exact prevalence is unknown and it is detected by way of an urinary measurement of creatine. ARC is defined as a creatinine clearance greater than 130 ml / min / 1.72 m2. Pathological mechanisms are not clearly defined and are probably multifactorial. For patients with confirmed ARC, dosing modifications of all renally purified medicinal products should be taken into account. The use of conventional doses can lead to the failure of the therapy with worse results for the patient and a higher economic cost for the healthcare system. Future research will determine dosages in ARC cases and the use of drug plasma concentration measurements will help us to individualize treatments.