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## Unstable Renal Function - Creatinine Clearance Methods

Program is used in patients with changing renal function. Requires two SCR Values
Patient Name    Location:
Age:    Sex:    Units for serum creatinine values:
Select serum creatinine reference standard:
Height    Weight:
Enter the time difference between the two serum creatinine values:

Important:   If the time difference between the values is less than one day, IGNORE the
Jelliffe and Brater results.  The only valid result when using shorter intervals is the output of the Chiou equation.

## Required for 'Jelliffe and Jelliffe' equation:

If serum creatinine values are RISING, enter the most RECENT SCR.  If SCR values are declining enter the AVERAGE VALUE between the two SCR values:

## Required for 'Jelliffe and Jelliffe', Brater, and Chiou equations:

Most recent SCR Value:
Earlier SCR Value

## Equations

Background equations
Estimated IBW:
Males: IBW = 50 kg + 2.3 kg for each inch over 5 feet.
Females: IBW = 45.5 kg + 2.3 kg for each inch over 5 feet.

AjBW = IBW + 0.4( ABW - IBW)

BSA (m2) = 0.007184 x Height(cm)0.725 x  Weight(kg)0.425

Jelliffe and Jelliffe
Ess (males) = IBW x (29.3 -[0.203 x (age)])
Ess (females) = IBW x (25.1 -[0.175 x (age)])

Correct Ess for nonrenal creatinine excretion in chronic renal failure
Esscorr = Ess x [1.035 - 0.0377(Scr)]
Scr  = If serum creatinine values are RISING, enter the most RECENT SCR.  If SCR values are declining enter the AVERAGE VALUE between the two SCR values.

E = Esscorr - [4 x IBW x (Scr2-Scr1)] /  (Time difference in days)
Scr2= latest serum creatinine.   Scr1= earlier serum creatinine.

CrCl (ml/min/1.73 M2) = E / (14.4 x Scr)
Brater Equation:
CLcr (mL/min/70 kg) =
[[293 - (2.03 x age)] x [1.035  - 0.01685 x (Scr1+ Scr2)]] / (Scr1+ Scr2)  +
[49 x (Scr1-Scr2)] /  (Scr1+ Scr2) x (Time difference in days)

Females:  Male value x 0.86.
Chiou et al  equation:
Vd (creat) = 0.6 L/kg
Male: CLcr (mL/min) = [2 x IBW x [28 - 0.2(age)] / 14.4 x (Scr1 + Scr2) ] +
[ 2 x [Vd (Scr1 - Scr2) ] / [(Scr1 + Scr2) x (Time difference (minutes))] ] - [Non-renal Clcr x IBW]

Female: CLcr (mL/min) = [2 x IBW x [22.4 - 0.16(age)] / 14.4 x (Scr1 + Scr2) ] +
[ 2 x [Vd (Scr1 - Scr2) ] / [(Scr1 + Scr2) x (Time difference (minutes))] ] - [Non-renal Clcr x IBW]

Non-renal Clcr = 0.048 mL.min-1.kg-1. IBW = Ideal body weight. Scr1 = First serum creatinine value. Scr2= Second serum creatinine value.

## References

1) Brater DC. Drug Use In Renal Disease. ADIS Health Science Press, Balgowlah, Australia 1983;22-56.

2) Burton, M.E., Shaw, L.M., Schentag, J.J., and Evans, W.E. (editors) 2006. Applied Pharmacokinetics & Pharmacodynamics, Principles of Therapeutic Drug Monitoring, Lippincott Williams & Wilkins, Baltimore, MD.

3) Chiou WL, Hsu FH. A new simnple and rapid method to monitor the renal function based on pharmacokinetic consideration of endogenous creatinine. Res Comm Chem Pathol Pharmacol 1975;10:315-330.

4) Devine BJ. Gentamicin therapy. Drug Intell Clin Pharm 1974;8:650-655.

5) DuBois D, DuBois DF. A formula to estimate the approximate surface area if height and weight be known. Arch Int Med 1916;17:863-71.

6) Jelliffe RW, Jelliffe SM. A computer program for estimation of creatinine clearance from unstable serum creatinine concentration. Math Biosci. 1972;14:17-24.
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