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Link to original content: https://pubmed.ncbi.nlm.nih.gov/21611081
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. 2011 May;32(2):81-8.

Estimating renal function for drug dosing decisions

Graham Rd Jones  1
Affiliations

Estimating renal function for drug dosing decisions

Graham Rd Jones. Clin Biochem Rev. 2011 May.

Abstract

In order to adjust the dose of renally excreted drugs in response to reduced renal function, it is necessary to make a quantitative estimate of the glomerular filtration rate (GFR) of the patient. Traditionally this has been done with the use of the Cockcroft and Gault equation or a measured creatinine clearance. More recently the MDRD (Modification of Diet in Renal Disease) formula has become available, providing an estimate of GFR readily available on routine pathology reports. The presence of these different methods of assessing renal function has created some confusion for healthcare workers as to the best approach. In this paper the two methods are compared, together with a newer formula CKD-EPI (named after the Chronic Kidney Disease Epidemiology Collaborative), and a proposal is made for future practice.

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Figures

Figure 1.
Figure 1.
Comparison of (A) MDRD values for eGFR (B), Cockcroft and Gault eGFR calculated using patient ideal body weight and (C) CKD-EPI with body surface area normalisation removed with Cockcroft and Gault eCrCl using actual body weight. Data is from 32,000 Australians presenting for routine measurement of serum creatinine (9). The solid line is the line of identity and the dashed lines indicate differences of +/− 30%.
Figure 2.
Figure 2.
Schematic diagram showing the effects of (A) applying and (B) removing body surface area normalisation in subjects with very different body sizes.
See this image and copyright information in PMC

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References

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