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April 1979

Creatinine Clearance in Critically Ill Surgical Patients

Author Affiliations

From the Department of Surgery, Wayne State University School of Medicine and Harper/Grace Hospitals, Detroit.

Arch Surg. 1979;114(4):461-467. doi:10.1001/archsurg.1979.01370280115017

• Standard tests of renal function (urine output, BUN, and serum creatinine) were compared with creatinine clearance values and with outcome in 131 critically ill surgical patients. There was a strong negative relationship between creatinine clearance and mortality. Of the 23 patients with a severe reduction of creatinine clearance (<20 mL/min), 17 died. In contrast, 23 of the 24 patients with a creatinine clearance of 100 mL/min or more survived. Urine output, BUN, and serum creatinine levels correlated poorly with creatinine clearance. A urine output of less than 30 mL/hr, a BUN level greater than 40 mg/dL, and a serum creatinine level greater than 2.0 mg/dL in all instances were associated with reduced creatinine clearances. However, more than half of all the patients with a normal urine output, BUN, or serum creatinine levels also had a reduced creatinine clearance.

(Arch Surg 114:461-467, 1979)