04.02 Renal Dosing

Question 1

CrCl _____estimates GFR

Answer 1

over

Question 2

Acute renal failure: SCr obtained before steady state will ______estimate the SCr and ______estimate CrCl and GFR

Answer 2

Acute renal failure: SCr obtained before steady state will UNDERestimate the SCr and OVERestimate CrCl and GFR

Question 3

Which method is good for Moderate/High GFR?

Answer 3

CKD-EPI

Question 4

Methods that adjust for race

Answer 4

MDRD and CKD-EPI

Question 5

Methods that predict CrCl

Answer 5

Cockcroft-Gault

Question 6

Methods that predict GFR

Answer 6

MDRD and CKD-Epi

Question 7

Good for low GFR

Answer 7

MDRD

Question 8

Best for ELDERLY

Answer 8

CKD-EPI marginally better than MDRD at GFR >60, both are better than CG

Question 9

CG _____estimates renal function and ______doses older patients

Answer 9

CG UNDERestimates renal function and UNDERdoses older patients

Question 10

Obesity

Answer 10

CG-ABW preferred (also CG-LBW or MDRD corrected for BSA)

Only use estimation as a starting point - due to the large variability in the estimation should measure GFR or CrCl

Question 11

IBW as a substitute for LBW _____estimates CrCl as obese patients have _____total lean body mass than normal weight pts

Answer 11

IBW as a substitute for LBW UNDERstimates CrCl as obese patients have GREATER total lean body mass than normal weight pts

Question 12

For patients with advanced age (>80yo), low body weight and modestly elevated SCr the _____method is superior

Answer 12

Cockcroft-Gault

Question 13

Critically ill ICU pts

Answer 13

Both CG and MDRD overestimate GFR - unsuitable

Obtain a 12-24 h CrCl measurement

Question 14

Children 1-16 years old

Answer 14

Schwartz equation:

0.413 x height (cm)/SCr