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      Estimation of Creatinine Clearance in Patients with Unstable Renal Function, without a Urine Specimen

      American Journal of Nephrology

      S. Karger AG

      Renal function, Creatinine clearance

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          Background: There is a significant need to estimate creatinine clearance easily in acutely ill patients with unstable renal function, who have rapidly changing serum creatinine values and who need careful individualization of drug dosage, all without the problems associated with having to collect the traditional carefully timed urine specimen. Method: The daily change in the total amount of creatinine is the difference between its production and excretion. Production is estimated based on studies by others, using many carefully timed urine specimens. Daily creatinine production is related both to age and to the serum creatinine concentration. Urinary excretion of creatinine is equal to creatinine clearance times the average of a pair of timed serum creatinine concentrations, times the duration of the collection (usually 24 h). Results: Good correlation was found between conventional measured creatinine clearances and the estimated values. The estimates had a precision essentially equal to that of the traditional method. Conclusions: One can now estimate the creatinine clearance which makes serum creatinine change from an initial concentration at one stated time to another concentration at another stated time, for a patient of a stated age, gender, height and weight, without requiring a urine specimen. This method has been incorporated into software to perform the calculations easily and rapidly, and has been integrated into the USC*PACK PC programs for planning, monitoring and adjusting individualized dosage regimens of drugs.

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          A computer program for estimation of creatinine clearance from unstable serum creatinine levels, age, sex, and weight


            Author and article information

            Am J Nephrol
            American Journal of Nephrology
            S. Karger AG
            August 2002
            02 August 2002
            : 22
            : 4
            : 320-324
            Laboratory of Applied Pharmacokinetics, Division of Geriatric Medicine, USC Keck School of Medicine, Los Angeles, Calif., USA
            65221 Am J Nephrol 2002;22:320–324
            © 2002 S. Karger AG, Basel

            Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

            Page count
            Figures: 1, Tables: 2, References: 6, Pages: 5
            Self URI (application/pdf):
            Clinical Study

            Cardiovascular Medicine, Nephrology

            Creatinine clearance, Renal function


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