# Measuring kidney function creatinine clearance crcl

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Measuring Kidney Function Creatinine Clearance (CrCl) Rate at which creatinine is filtered through glomerulus Can be considered an estimation of GFR Creatinine also undergoes tubular secretion Augments filtered creatinine by 10% Normal = 85-135 ml/min Use as an estimate of renal function when dosing drugs

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GFR vs Creatinine Clearance In clinical practice Mathematical equations are used to estimate GFR and creatinine clearance MDRD equation estimates GFR Cockcroft-Gault equation estimates creatinine clearance Diagnose or staging chronic kidney disease MDRD or Cockcroft-Gault Adjusting medication doses in patients with renal insufficiency Cockcroft-Gault
MDRD Equation 175 * (SCr) -1.154 * (Age) -0.203 Multiply by 1.21 if African American Multiply by 0.742 if female Units = ml/min/1.73m 2

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Case PT is a 66 year old African American female. Her SCr is 1.2 mg/dL and she weighs 96kg. What is her GFR?
Case PT is a 66 year old African American female. Her SCr is 1.2 mg/dL and she weighs 96kg. What is her GFR? 175 * (1.2) -1.154 * (66) -0.203 * 1.21 * 0.742 = 54.4 ml/min/1.73m 2

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What is the GFR of a 45 year old Asian man with a SCr of 0.9? 1. 81.9 ml/min/1.73m 2 2. 91.3 ml/min/1.73m 2 3. 110 ml/min/1.73m 2 4. I got something else!
Answer 175 * (0.9) -1.154 * (45) -0.203 = 91.3 ml/min/1.73m 2

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Cockcroft-Gault 140-age * Ideal Body Weight SCr * 72 CrCl (ml/min) = 0.85 (female) *
Ideal body weight Ideal Body Weight (IBW) (in kg): Females = 45.5 + (2.3 * inches over 60”) Males = 50 + (2.3 * inches over 60”) If patient weighs less than IBW, use actual body weight

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Clinical Controversy Some practitioners calculate an adjusted body weight for obese patients
Cockcroft-Gault Rounding SCr Elderly patients (> 65 years old) If SCr < 1, use SCr of 1 in Cockcroft-Gault Equation

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PQ is a 56 y/o M who is 5’10” and weighs 93 kg. His SCr is 1.5mg/dL. What is his ideal body weight?
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