Related Experiment Video
Updated: Feb 26, 2026
Ischemia-reperfusion Model of Acute Kidney Injury and Post Injury Fibrosis in Mice
Published on: August 9, 2013
Evaluation of 6-hour urine creatinine clearance as the kidney component in the SOFA score: An observational cohort
Liran Statlender1,2, Tzippy Shochat3, Mzia Moshiashvili4
1Department of General Intensive Care, Rabin Medical Centre, Beilinson Hospital, Petah Tikva, Israel.
Background:
The Sequential Organ Failure Assessment (SOFA) score, originally designed to reflect disease severity, is now recognized as a prognostic tool for critically ill patients. Recently, calls have emerged to update the score to better align it with contemporary clinical practice.
Methods:
This single-center, prospective, observational study was conducted in a general intensive care unit (ICU) of a university-affiliated tertiary hospital from September 10, 2023, to January 7, 2025. Urinary creatinine clearance (CrCl) was calculated daily using 6-h urine collection (CrCl6h) obtained during the first five nights after admission. Based on CrCl and Kidney Disease: ImprovingGlobal Outcomes (KDIGO) chronic kidney disease criteria, patients were categorized into five groups (0-4), with subsequent calculation of a modified SOFA score according to this grouping. The predictive ability of serum creatinine (Scr), urine output, CrCl6h, the original SOFA score, and the modified SOFA score for ICU and 90-day mortality was compared by evaluating their area under the receiver operating characteristic (AUROC) values.
Results:
A total of 200 patients were included in the study. The ICU mortality for these patients was 12.0% while the 90-day mortality reached 29.5%. Compared with Scr, CrCl6h displayed significantly higher AUROC values for mortality prediction on almost all days examined. For example, on day 3, the AUROC values were 0.821 vs. 0.730 (P=0.003) for ICU mortality, and 0.760 vs. 0.662 (P=0.002) for 90-day mortality. Similarly, the modified SOFA score showed significantly greater predictive performance on most days assessed. On day 3, the AUROC values were 0.791 vs. 0.706 (P=0.046) for ICU mortality, and 0.741 vs. 0.655 (P=0.007) for 90-day mortality.
Conclusion:
The categorization of urinary CrCl based on a 6-h urine collection can improve the ability of the SOFA score for predicting mortality.Trial Registration:Clinicaltrials.gov Identifier: NCT06779331.
Related Concept Videos
01:25Drug Dosing in Renal Diseases: Measurement of Serum Creatinine Concentration and Clearance
01:28Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration
01:17Factors Affecting Renal Clearance: Renal Impairment
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
01:23Renal Clearance
Renal clearance refers to the volume of plasma cleared of a specific substance, such as creatinine, per unit of time. To measure clearance, urine samples are collected over a 24-hour period during each bladder voiding, followed by a single blood sample at the...
01:25Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate
01:07Determination of Renal Drug Clearance: Graphical and Midpoint Methods
The graphical method involves plotting the rate of drug excretion in urine against the plasma drug concentration. By analyzing the graph, the clearance can be calculated and obtained. Drugs rapidly excreted by the kidneys exhibit a...