Augmented Renal Clearance

What could be the first thing that shows up in your mind when you hear the word “Kidney” or see a picture of a kidney? Probably, Acute kidney injury? Chronic kidney Disease? or Hemodialysis? Yes, you are right! These are the most frequent terms related to KIDNEY! However, did you ever think that there is a diseased kidney but with an opposite scenario, where the kidneys are working more effectively than they should!

Augmented Renal Clearance (ARC) is a recently described phenomenon for patients having super kidneys! Routinely, the kidney function is assessed using creatinine clearance (CrCl) values. A normal individual would have a CrCl of 120 ml/min. However, patients with ARC have CrCl > 130 ml/min. Consequences of such a phenomenon include therapy failure due to the over-eliminating power of the kidney in excretion medications from your body. 50% of marketed medications are renally eliminated. Therefore, patients suffering from ARC should be carefully monitored due to the potential of poor therapeutic outcomes. Interestingly, not all patients suffer from ARC. Studies have shown that ARC is more susceptible to : 1) male patients 2) critically ill patients admitted to the intensive care unit 3) Younger population. In summary, ARC is an essential phenomenon that clinicians should be aware of for optimization of patients dosing. Consequences of ARC could lead to poor clinical outcomes, unless proactively monitored by the healthcare team.