Fluorescent Probe for Assessment of Renal Elimination
Aaron Cook
Summary
Accurate measures of kidney function is important for precision dosing of many medications. The current methods of determining kidney function largely hinge on the use of equations that use common laboratory values such as serum creatinine \& static variables like age \& weight. These are helpful for trending over time, but often are inaccurate during times of medical illness. Other more accurate methods of measuring kidney function include urine collection, although this is not commonly used because of various reasons that make the collection inconvenient or unreliable. The new transdermal glomerular filtration (tGFR) device permits accurate, real-time evaluation of kidney function. This novel method has not been rigorously compared with urine collection \& other methods of determining kidney function in hospitalized patients. The goal of the study is to compare tGFR with other accepted methods of determining kidney function.
Description
The majority of acutely ill patients exhibit changes in renal function due to inflammation, increased solute generation, and iatrogenic factors such as fluid resuscitation and vasopressors. The pharmacokinetics of renally eliminated medications (eg. levetiracetam, cefepime, vancomycin) are frequently affected by inflammatory processes despite normal estimations in creatinine clearance resulting in suboptimal serum drug concentrations and therapeutic failure. Despite the prevalence of fluctuations in renal function in acute illness, real-time assessment is limited to monitoring of serum biomark…
Eligibility
- Age range
- 18–65 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * 18-65 years old * critically ill or acutely ill hospitalized patients admitted to the intensive care unit * Stable/normal renal function Exclusion Criteria: * Prisoners * Pregnant women * Laboratory evidence of unstable kidney function (KDIGO AKI stage 1-3--This includes subjects with Scr \> 1.5x baseline)
Interventions
- DrugRelmapirazin
IV push of relmapirazin (Lumitrace) prior to use of the tGFR device
- DrugIohexol
Small IV push bolus of iohexol as a probe for renal function will be administered prior to use of the tGFR device.
- DeviceMedibeacon tGFR monitor
The tGFR monitor will be applied to the patient after relmapirazin bolus for measurement of GFR.
- Diagnostic TestUrine creatinine clearance collection
8-hour urine creatinine clearance collection will be performed during the study period to compare to tGFR \& other renal function measures.
Location
- UKHealthCare/University of KentuckyLexington, Kentucky