Rico-Fontalvo Jorge, Correa-Guerrero José, Martínez-Ávila María Cristina, Daza-Arnedo Rodrigo, Rodriguez-Yanez Tomás, Almanza-Hurtado Amilkar, Cabrales José, Mendoza-Paternina Carmen Julia, Frías-Salazar Alvaro, Morales-Fernández Julio
Colombian Association of Nephrology and Hypertension, Bogota, Colombia.
Intensive Care Unit Universidad de Cartagena, Cartagena, Colombia.
Int J Nephrol. 2023 Feb 28;2023:6059079. doi: 10.1155/2023/6059079. eCollection 2023.
Renal hyperfiltration (RHF) is a prevalent phenomenon in critically ill patients characterized by augmented renal clearance (ARC) and increased of elimination of renally eliminated medications. Multiple risk factors had been described and potential mechanisms may contribute to the occurrence of this condition. RHF and ARC are associated with the risk of suboptimal exposure to antibiotics increasing the risk of treatment failure and unfavorable patient outcomes. The current review discusses the available evidence related to the RHF phenomenon, including definition, epidemiology, risk factors, pathophysiology, pharmacokinetic variability, and considerations for optimizing the dosage of antibiotics in critically ill patients.
肾性高滤过（RHF）是危重症患者中普遍存在的现象，其特征为肾清除率增加（ARC）以及经肾脏排泄药物的消除增加。已描述了多种风险因素，潜在机制可能导致这种情况的发生。RHF和ARC与抗生素暴露不足的风险相关，增加了治疗失败和患者不良结局的风险。本综述讨论了与RHF现象相关的现有证据，包括定义、流行病学、风险因素、病理生理学、药代动力学变异性以及危重症患者抗生素剂量优化的注意事项。
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