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Calculate
the clearance of a continuous renal replacement therapy
(CRRT) system. This calculation applies to pre-filter replacement
configurations only, not post-filter replacement or diafiltration
methods.
The
units for the Blood Flow Rate, Ultrafiltration Rate, and Replacement
Rate settings are usually different from one another. They
must first be converted to the same units as the Clearance.
The
Plasma Concentration can be for any solute, but the actual
value is unimportant; only the ratio to the Ultrafiltrate
Concentration matters. (Note that protein binding will diminish
actual clearance of specific solutes). Similarly, the units
for Plasma Concentration and Ultrafiltrate Concentration cancel
out and thus need not be specified. The Ultrafiltrate Concentration
equals the Plasma Concentration times the Blood Flow Rate
divided by the sum of the Blood Flow Rate and the Replacement
Rate (after converting the units). This Ultrafiltrate Concentration
would equal the concentration of that solute in the blood
returning to the patient if there is no protein binding. If
the protein binding is not insignificant, the Ultrafiltrate
Concentration would be multiplied by quantity 1 - Protein
Bound Fraction.
The
formula for the calculation of clearance (in this case creatinine)
is:
| CrCl
= |
UCr
* UVol |
 |
| PCr
* Tmin |
For
continuous renal replacement therapy, the ultrafiltrate is
the "urine."
Note
that when the Replacement Rate is zero, the Clearance is equivalent
to the Ultrafiltration Rate (in mL/min rather than mL/hr).
Also note that the initial Plasma Concentration ultimately
does not affect the Clearance.
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