Comparison of creatinine clearance estimation methods in patients with trauma

The abilities of a modified Cockcroft-Gault equation and the standard equation to estimate creatinine clearance (CLcr) in trauma patients were compared. The medical records of patients with stable renal function who had been treated for trauma and had had a 24-hour urine collection for creatinine me...

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Veröffentlicht in:American journal of health-system pharmacy 1996-05, Vol.53 (9), p.1028-1032
Hauptverfasser: Davis, GA, Chandler, MH
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container_title American journal of health-system pharmacy
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creator Davis, GA
Chandler, MH
description The abilities of a modified Cockcroft-Gault equation and the standard equation to estimate creatinine clearance (CLcr) in trauma patients were compared. The medical records of patients with stable renal function who had been treated for trauma and had had a 24-hour urine collection for creatinine measurement were reviewed. Creatinine concentrations in urine and serum were used to calculate the actual CLcr, which was normalized to 1.73 sq m. CLcr was estimated by the modified equation (which normalized body weight to 72 kg) and by the standard equation using ABW, IBW, and dosing body weight (DBW). Values derived with the standard equation were normalized to 1.73 sq m. The predictive performances of the modified and standard equations in estimating the actual CLcr were then compared. Fifty patients were enrolled. The standard equation using IBW or DBW produced estimates that differed significantly from the actual CLcr. The modified equation and the standard equation using ABW did not differ significantly in bias or precision, but both were significantly less biased than the standard equation using IBW or DBW. The only significant difference among equations in precision was between the modified equation (the more precise) and the standard equation using IBW. There were no clinically significant differences among methods in gentamicin dosing simulations. The modified Cockcroft-Gault equation can be used to estimate CLcr in trauma patients with stable renal function.
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The medical records of patients with stable renal function who had been treated for trauma and had had a 24-hour urine collection for creatinine measurement were reviewed. Creatinine concentrations in urine and serum were used to calculate the actual CLcr, which was normalized to 1.73 sq m. CLcr was estimated by the modified equation (which normalized body weight to 72 kg) and by the standard equation using ABW, IBW, and dosing body weight (DBW). Values derived with the standard equation were normalized to 1.73 sq m. The predictive performances of the modified and standard equations in estimating the actual CLcr were then compared. Fifty patients were enrolled. The standard equation using IBW or DBW produced estimates that differed significantly from the actual CLcr. The modified equation and the standard equation using ABW did not differ significantly in bias or precision, but both were significantly less biased than the standard equation using IBW or DBW. 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Antiinfectious agents. Antiparasitic agents</topic><topic>Biological and medical sciences</topic><topic>Body Weight</topic><topic>Creatinine - blood</topic><topic>Creatinine - metabolism</topic><topic>Creatinine - urine</topic><topic>Female</topic><topic>Gentamicins - pharmacokinetics</topic><topic>Glomerular Filtration Rate</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Metabolic Clearance Rate</topic><topic>Middle Aged</topic><topic>Pharmacology. 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identifier ISSN: 1079-2082
ispartof American journal of health-system pharmacy, 1996-05, Vol.53 (9), p.1028-1032
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source MEDLINE; Oxford University Press Journals All Titles (1996-Current)
subjects Adult
Age Factors
Anti-Bacterial Agents - pharmacokinetics
Antibacterial agents
Antibiotics. Antiinfectious agents. Antiparasitic agents
Biological and medical sciences
Body Weight
Creatinine - blood
Creatinine - metabolism
Creatinine - urine
Female
Gentamicins - pharmacokinetics
Glomerular Filtration Rate
Humans
Male
Medical sciences
Metabolic Clearance Rate
Middle Aged
Pharmacology. Drug treatments
Wounds and Injuries - blood
Wounds and Injuries - metabolism
Wounds and Injuries - urine
title Comparison of creatinine clearance estimation methods in patients with trauma
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