Estimation of Creatinine Clearance

The Cockroft Equation (Nephron 1976; 16:31) It is adequate for most adult patients with normal muscle mass and serum creatinine (Scr) < 4.5 mg/dL CLcr (male) = IBW (140 - Age) / 72Scr) CLcr (female)= 0.85 IBW (140 - Age)/(72 Scr) Where: A = age in yrs; IBW = Ideal Body Weight in Kg

The Sanaka equation

(Nephron 1996; 73:137-144 ) For elderly pts (>60) with very low muscle mass and who do not have nephrotic syndrome or severe hepatic disease, the CLcr may be estimated by the Sanaka equation: CLcr (male) = ABW (19 Alb +32) / 100 Scr CLcr female)= ABW (13 Alb +29) / 100 Scr Where: Alb = plasma albumin level (g/dL); Scr = serum creatinine (mg/dL). ABW = actual body weight in Kg The metric version of the Sanaka equations: CLcr (male) = ABW (2 Alb + 35) / 1.24 Scr CLcr (female) = ABW (Alb + 22) / 0.87 Scr Where: Alb = plasma albumin level (g/dL); Scr = serum creatinine (m/L). ABW = actual body weight in Kg

Ideal Body Weight

Non-metric Version IBW (male) = 50 + 2.3 (H - 60) IBW (fem) = 45.5 + 2.3 (H - 60) IBW= ideal body weight (Kg); H = height in inches The metric version IBW (male) = 0.9 H - 88 IBW (fem) = 0.9 H - 92 H = height in centimeters. Dosing Weight = DW = IBW + 0.4 (ABW - IBW) Where: ABW = actual body wt. in Kg

Jelliffe Equation
Good for adult pts with normal muscle mass and Scr <5 mg/dL. CLcr (male) = (114 - 0.8A) / Scr CLcr (female) = 0.9 (114 - 0.8A)/Scr Where: A = age in yrs; CLcr = creatinine clearance in mL/min/1.73 m2 Note: The pt's BSA must be determined, and the CLcr value obtained by the above equation must be multiplied by (BSA/1.73) to obtain the pt's creatinine clearance in absolute terms (i.e.,

mL/min). BSA = Square Root of (Ht x Wt /3600); Wt = weight in kgs and Ht = height in cm).

Pediatric Patients
I- Traub-Johnson Equation (Am J Hosp Pharm 1980, 37:195). This equation may be used for children 1 - 16 yrs old. CLcr = 0.28 * H * BSA /Scr Where: H = height in cm; BSA = body surface area (m2) BSA = Square Root of (H x W / 3600); (W = weight in kgs and Ht = height in cm) II- Schwartz Equation (Ped Clinics of America, 1987: 34:571)

CLcr = k*H/Scr
Where: H = height in cm; Scr = serum creatinine concentration (mg/dL); k = propotionality constant whose value depends on several factors as shown below: Age low birth weight babies, <1 yr old Term (average gestational age) babies, <1 yr old Children (1 - 12) and adolescent girls Adolescent boys (13 - 17 yrs) k value 0.33 0.45 0.55 0.70