27 Risk factors of augmented renal clearance in critically ill children using iohexol clearance for renal function assessment

Introduction Augmented renal clearance(ARC) of hydrophilic drugs is frequent in PICU patients and warrants adjustment standard dosing regimens to prevent therapeutic failure. Knowledge patient-, disease- therapy-related factors associated with ARC, would allow predict before the start treatment, which benefit from higher drug doses. We aimed identify predictors ARC critically ill children normal serum creatinine(Scr) using iohexol plasma clearance (CLiohexol) quantify function. Methods performed a post hoc analysis data collected an interventional study conducted at our academic PICU, measured glomerular filtration rate (GFR) by CLiohexol Scr. was defined as GFR exceeding values for age plus 2 deviations. Multivariable logistic regression ARC. Results 85 patients, median 16 [IQR 5;89] months, 59% had surgical profile. Median 122[IQR 75;152] ml/min/1.73m2. Fourthy out (47%) expressed Postoperative status identified independent predictor (p=0.014, OR 4.253, 95%CI 1.338–13.517). However, after cardiac surgery odds developing were significantly lower (p=0.010, 0.163, 0.041 –0.644). There trend suggesting more male those without need vaso-active drugs, however, this not statistically significant. Conclusion Our findings raise clinicians’ awareness about potentially being present major surgery. This knowledge allows anticipate on enhanced elimination empirically adjusted immediately treatment.