Renal Function Measurement Flashcards
Who do we do direct measure of creatinine clearance in?
Acute kidney failure
Critically ill
Severe liver disease
Muscular dystrophy disorders
Who was the Cockcroft-Gault equation developed in?
Male
Caucasian
Who was the MDRD equation developed in?
Had European Americans, African Americans, more females
Who was the CKD-EPI equation develped in?
Not many older adults, minorities
What is the recommended method for older adults?
Use more than 1 method. Can average the results.
How does Cockcroft-Gault estimate older adults?
Underestimate
How does MDRD/CKD-EPI estimate older adults?
Overestimate
How does Cockcroft-Gault and MDRD estimate critically ill patients?
Overestimate
What is the recommended method for obese patients (greater than/equal to 30 kg/m2)?
Use CG and ABW OR
MDRD/CKD-EPI and adjusted BSA
What is the recommended method for obese patients (greater than/equal to 40 kg/m2)?
Use CG and ABW or lean body mass
What is the recommended method for low body weight/malnourished patients?
Use MDRD/CKD-EPI and correct for BSA
OR
Use total body weight in CG
What is the recommended method in children?
< 1: measure directly
1 - 16: Bedside Schwartz Equation
How does kidney dysfunction affect bioavailability?
Unchanged or increased (high first pass)
How does kidney dysfunction affect Vd?
Increased, decreased, or unchanged (depends on unbound fraction, related to albumin levels)
How does kidney dysfunction affect clearance?
Depends on fraction excreted unchanged of total drug
