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Determining the mechanisms underlying augmented renal drug clearance in the critically ill: use of exogenous marker compounds

Overview of attention for article published in Critical Care, November 2014
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (80th percentile)
  • Above-average Attention Score compared to outputs of the same age and source (56th percentile)

Mentioned by

twitter
4 tweeters
patent
1 patent
facebook
1 Facebook page
googleplus
1 Google+ user

Citations

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51 Dimensions

Readers on

mendeley
66 Mendeley
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Title
Determining the mechanisms underlying augmented renal drug clearance in the critically ill: use of exogenous marker compounds
Published in
Critical Care, November 2014
DOI 10.1186/s13054-014-0657-z
Pubmed ID
Authors

Andrew A Udy, Paul Jarrett, Janine Stuart, Melissa Lassig-Smith, Therese Starr, Rachel Dunlop, Steven C Wallis, Jason A Roberts, Jeffrey Lipman

Abstract

IntroductionThe aim of this study was to explore changes in glomerular filtration (GFR) and renal tubular function in critically ill patients at risk of augmented renal clearance (ARC), using exogenous marker compounds.MethodsThis prospective, observational pharmacokinetic (PK) study was performed in a university affiliated, tertiary level, adult intensive care unit (ICU). Patients aged more than or equal to 60 years, manifesting a systemic inflammatory response, with an expected ICU length of stay more than 24 hours, no evidence of acute renal impairment (plasma creatinine concentration <120 ¿mol/L), and no history of chronic kidney disease or renal replacement therapy, were eligible for inclusion. The following study markers were administered concurrently; sinistrin 2500 mg (Inutest®, Laevosan, Linz, Austria), p-Aminohippuric acid (PAH) 440 mg (4% p-Aminohippuric acid sodium salt, CFM Oskar Tropitzsch, Marktredwitz, Germany), rac-pindolol 5 or 15 mg (Barbloc®, Alphapharm, NSW, Australia) and fluconazole 100 mg (Diflucan®, Pfizer Australia Pty Ltd, NSW, Australia). Plasma concentrations were then measured at 5, 10, 15, 30, 60, 120 min, 4, 6, 12, and 24 hours post administration. Non-compartmental PK analysis was used to quantify GFR, tubular secretion, and tubular reabsorption.ResultsTwenty patients were included in the study. Marker administration was well tolerated, with no adverse events reported. Sinistrin clearance as a marker of GFR was significantly elevated (mean 95% CI ¿ 180 (141 to 219) mL/min), and correlated well with creatinine clearance (r =0.70, P <0.01). Net tubular secretion of PAH, a marker of tubular anion secretion, was also elevated (428 (306 to 550) mL/min), as was net tubular reabsorption of fluconazole (135 (100 to 169) mL/min). Net tubular secretion of (S)- and (R)-pinodolol, a marker of tubular cation secretion, was impaired.ConclusionsIn critically ill patients at risk of ARC, significant alterations in glomerular filtration, renal tubular secretion and tubular reabsorption are apparent. This has implications for accurate dosing of renally eliminated drugs.

Twitter Demographics

The data shown below were collected from the profiles of 4 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 66 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Japan 1 2%
Brazil 1 2%
Unknown 64 97%

Demographic breakdown

Readers by professional status Count As %
Student > Master 13 20%
Other 10 15%
Student > Ph. D. Student 8 12%
Student > Bachelor 7 11%
Researcher 5 8%
Other 15 23%
Unknown 8 12%
Readers by discipline Count As %
Medicine and Dentistry 36 55%
Pharmacology, Toxicology and Pharmaceutical Science 14 21%
Biochemistry, Genetics and Molecular Biology 2 3%
Agricultural and Biological Sciences 1 2%
Computer Science 1 2%
Other 1 2%
Unknown 11 17%

Attention Score in Context

This research output has an Altmetric Attention Score of 7. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 18 February 2021.
All research outputs
#3,681,223
of 18,672,358 outputs
Outputs from Critical Care
#2,570
of 5,489 outputs
Outputs of similar age
#62,094
of 324,096 outputs
Outputs of similar age from Critical Care
#58
of 137 outputs
Altmetric has tracked 18,672,358 research outputs across all sources so far. Compared to these this one has done well and is in the 80th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 5,489 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 17.1. This one has gotten more attention than average, scoring higher than 52% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 324,096 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 80% of its contemporaries.
We're also able to compare this research output to 137 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 56% of its contemporaries.