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Introduction: Augmented Renal Clearance (ARC) reflects a measured creatinine clearance (CrCl) of more than 130 ml/min. Also, there are two scoring systems for the prediction of the ARC phenomenon i.e., the ARC score (ARCS) and the Augmented Renal Clearance in Trauma Intensive Care score (ARCTICs). The objectives of the current study were the evaluation the effect of using both scoring systems, on the chance of identifying this phenomenon and evaluating the accuracy of the three commonly used formulas for estimating glomerular filtration rate (eGFR) in ICU patients.Methods: In this prospective cross-sectional study, the CrCls of all patients admitted to the ICU were evaluated by using ARCS and ARCTICS, and for high-risk subjects based on scoring systems, a 12-hour urine sample was collected to measure CrCl. Besides, daily serum creatinine was recorded to estimate the daily eGFR.Results: During the study period, 810 subjects were evaluated and 145 were categorized as high-risk using scoring systems. The ARC phenomenon was confirmed in 79 patients on the recruitment day and 81.01 and 18.98% of them were recruited by ARCS and ARCTICS, respectively. The ROC curves showed AUCs > 0.5 for CockcroftGault (C-G) and CKD-EPI with the cut-off of 100.48 and 107.05 mL/min/ 1.73m2, respectively; to detect the ARC phenomenon.Conclusion: We recommend using ARCS and ARCTICS simultaneously to assess critically ill patients regarding the possibility of the ARC phenomenon which should be confirmed by using urinary CrCl, as none of the formulas could accurately detect the ARC phenomenon, neither the 12-hour CrCl.  DOI: 10.52547/ijkd.6695. [ABSTRACT FROM AUTHOR]

Introduction: Magnetic resonance imaging (MRI) sequence acquisition techniques for iron assessment have revolutionized the study of iron overload in different organs. We hypothesized that MRI can accurately and reliably assess possible iron deposition in the myocardium and liver by measurement of T2* value. Materials and Methods: Seventeen patients with end-stage renal disease on hemodialysis were enrolled. An electrocardiography-gated single breath hold fast multiecho T2* sequence was acquired in the short axis at basal and mid-ventricular levels. The same technique was utilized to estimate liver parenchyma iron content. Results: Iron deposition in the liver was present in 50% of the hemodialysis patients. No iron deposition was found in the myocardium. A strong univariable inverse linear association was detected between serum albumin and T2* in the liver (r = -0.84, P < .001). Patients who had been on dialysis for 10 years and longer had a 91% reduction in their odds of developing iron overload in the liver compared to the referent group (exact odds ratio, 0.09; P = .048). Conclusions: Even though using intravenous iron infusion is a common practice in chronic dialysis patients, it seems the myocardium as opposed to the liver is resistant to or protected against iron deposition. There were no meaningful differences in the relationship between iron overload in the liver and the dialysis time vintage. A more aggressive trend of iron therapy and different formulations of iron infusion could be an explanation of iron deposition in the liver. [ABSTRACT FROM AUTHOR]

With the rising incidence of metabolic syndrome and progressive kidney disease, efforts to halt this progression have become the mainstay of therapies in the era of modern nephrology. The necessity of one versus two kidneys has occupied the minds of leading scientists and philosophers throughout the ages and has laid the foundation for our understanding of progressive kidney disease. This review focuses on the major discoveries of the leading thinkers who with their paradigm shifting ideas and skepticism pushed the boundaries of our knowledge and shaped the theory of hyperfiltration. [ABSTRACT FROM AUTHOR]