QuantRenalFunctFall2012WithAnswers (1)

Measuring kidney function creatinine clearance crcl

Info icon This preview shows pages 14–26. Sign up to view the full content.

View Full Document Right Arrow Icon
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
Image of page 14

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
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
Image of page 15
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
Image of page 16

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
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?
Image of page 17
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
Image of page 18

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
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!
Image of page 19
Answer 175 * (0.9) -1.154 * (45) -0.203 = 91.3 ml/min/1.73m 2
Image of page 20

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Cockcroft-Gault 140-age * Ideal Body Weight SCr * 72 CrCl (ml/min) = 0.85 (female) *
Image of page 21
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
Image of page 22

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Clinical Controversy Some practitioners calculate an adjusted body weight for obese patients
Image of page 23
Cockcroft-Gault Rounding SCr Elderly patients (> 65 years old) If SCr < 1, use SCr of 1 in Cockcroft-Gault Equation
Image of page 24

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
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?
Image of page 25
Image of page 26
This is the end of the preview. Sign up to access the rest of the document.

{[ snackBarMessage ]}

What students are saying

  • Left Quote Icon

    As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.

    Student Picture

    Kiran Temple University Fox School of Business ‘17, Course Hero Intern

  • Left Quote Icon

    I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.

    Student Picture

    Dana University of Pennsylvania ‘17, Course Hero Intern

  • Left Quote Icon

    The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.

    Student Picture

    Jill Tulane University ‘16, Course Hero Intern