Augmented renal clearance in patients after hepatobiliary-pancreatic surgery at an intensive care unit: case-control study

Abstract

Objective: Augmented renal clearance (ARC) has been reported in critically ill patients with trauma and sepsis. In this study, we investigated the occurrence of ARC following major hepatobiliary-pancreatic (HBP) surgery, which has rarely been reported. Methods: We conducted a case-control study to investigate factors associated with ARC development following HBP surgery and examined methods for evaluating renal function. Patients who underwent HBP surgery and were admitted to our ICU between October 2018 and March 2021 were retrospectively reviewed. Creatinine clearance (CrCl) by 6-hour urine collection ≥130 mL/ min/1.73 m² was defined as ARC. Results: In total, 144 patients were evaluated. The incidence of ARC was 38.2% (n=55). Multivariate analysis showed that age, estimated glomerular filtration rate (eGFR) before surgery, and intraoperative transfusion of red blood cells were associated with ARC incidence. In the case of ARC, a proportional error was found between the eGFR and CrCl. Conclusion: ARC occurs at a high rate after major HBP surgery. The evaluation of renal function using CrCl is necessary to recognize ARC development.