2023 MeRIT Primer Participants – Proposed Research
Sunday, November 12, 2023
12:45 PM–02:15 PM
Abstract
Introduction:
Assessment of kidney function is essential to optimizing efficacy and safety of drug dosing. Use of serum creatinine (SCr) has significant limitations related to sensitivity and specificity; and can be impacted by non-kidney factors like muscle mass, protein intake, sex, race, drugs that interfere with tubular secretion, and volume status. Cystatin C (CysC) is less affected by non-kidney factors and has been suggested as an alternative or additional method to estimate kidney function. Previous studies have suggested that CysC may be useful in estimating kidney function in hospitalized patients; CysC has been incompletely investigated in critically ill patients.
Research Question or Hypothesis:
There is discordance in estimated glomerular filtration rate (eGFR) between SCr-based calculations and CysC-based calculations that impacts dosing of renally-adjusted medications in critically ill patients.
Study Design:
This is a single-center, retrospective observational cohort study at an academic medical center including adult patients admitted to an intensive care unit between 06/01/2023 and 12/31/2023 with SCr and CysC ordered. The primary outcome is discordance rate of renal drug dosing between SCr-based calculations and SCr/CysC-based calculations
Methods:
Data will be collected through chart review. In addition to SCr and CysC values, demographic data will be collected with a focus on factors that could contribute to discordant estimates of kidney function related to SCr and CysC limitations. Demographic data will be presented as descriptive statistics. Discordance rate will be defined as the percentage of times at which there is at least one discrepancy in renal dosing for a medication using Cockcroft-Gault creatinine clearance versus Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) eGFR-SCr versus CKD-EPI eGFR-SCr/CysC equations. Correlation will be analyzed by Spearman linear regression. Bias, precision, and accuracy analyzed by Bland-Altman analysis.
Results:
Anticipated in Spring/Summer 2024.
Conclusion:
To be determined, pending results.
Presenting Author
Victoria Williams PharmD, BCCCPThe Ohio State University College of Pharmacy
Authors
Anthony Gerlach PharmD, BCPS, FCCM
The Ohio State University Wexner Medical Center