Clearing the Way; Simplifying Creatinine Clearance Calculations for Renal Dose Adjustments －A Retrospective Analysis

Abstract

Purpose: Previous data demonstrate that a simplified creatinine clearance calculation using only age, sex, and serum creatinine provides similar creatinine clearance estimates relative to more complex calculations when compared to a standard 24 hour urine creatinine measurement. A simplified equation may improve the availability and timeliness of creatinine clearance estimates to guide medication dosing for acute patient care needs. The aim of this analysis was to determine how medication renal dose adjustments would be affected using the simplified creatinine clearance calculation as compared to our current standard, a modified Cockcroft-Gault equation. Methods: A retrospective chart review is being conducted at Upstate University Hospital, a tertiary, academic medical center. A patient list was created that includes patients from the general medicine, surgery, orthopedics, cardiothoracic, neurosurgery, intensive care units, and hematology/oncology floors. Records were then reviewed to include patients prescribed medications that may require renal dose adjustments. Only medications with clearly defined renal dose adjustments per hospital protocol are being included. Patients on continuous veno-venous hemofiltration are excluded. Data collection includes patient demographics, serum creatinine, and medication dosing.  Specific renal-dose adjustments of medications are being determined using hospital protocol. Dose adjustments will be determined using both the simplified calculation and our current standard, a modified Cockcroft-Gault equation. Differences in resulting dose adjustments between equations will be identified and compared. A retrospective chart review is being conducted at our tertiary academic medical center. A patient list was created that includes patients from the general medicine, surgery, orthopedics, cardiothoracic, neurosurgery, intensive care units, and hematology/oncology floors. Records were then reviewed to include patients prescribed medications that may require renal dose adjustments. Only medications with clearly defined renal dose adjustments per hospital protocol are being included. Patients on continuous veno-venous hemofiltration are excluded. Data collection includes patient demographics, serum creatinine, and medication dosing.  Specific renal-dose adjustments of medications are being determined using hospital protocol. Dose adjustments will be determined using both the simplified calculation and our current standard, a modified Cockcroft-Gault equation. Differences in resulting dose adjustments between equations will be identified and compared