A 55-year-old man on ICU has severe sepsis with AKI. His serum creatinine is 350 µmol/L. He is on IV meropenem 1g TDS. The pharmacist notes he has a m...

Question

A 55-year-old man on ICU has severe sepsis with AKI. His serum creatinine is 350 µmol/L. He is on IV meropenem 1g TDS. The pharmacist notes he has a measured creatinine clearance (8-hour urine collection) of 160 mL/min - much higher than the eGFR would suggest. What phenomenon does this represent?

Accepted Answer

Augmented renal clearance (ARC) - despite the elevated creatinine (which reflects the recent AKI and has not yet equilibrated), the measured creatinine clearance reveals supranormal renal function in the recovery phase; this is common in young, septic patients and causes subtherapeutic antibiotic levels at standard doses

Answer

Laboratory error

Answer

Chronic kidney disease

Answer

The creatinine clearance measurement is always unreliable

Answer

This is impossible

uk-fficm MCQ (SBA): ARC During AKI Recovery

A 55-year-old man on ICU has severe sepsis with AKI. His serum creatinine is 350 µmol/L. He is on IV meropenem 1g TDS. The pharmacist notes he has a measured creatinine clearance (8-hour urine collection) of 160 mL/min - much higher than the eGFR would suggest. What phenomenon does this represent?