Hi everyone,Back to the Top
I would like to know what the most common methods of measuring renal
If someone is able to brief me, that would be much appreciated.
Undergraduate Pharmacy Student
Linda,Back to the Top
Take a look at the paper I wrote a few years ago:
Drug interactions at the renal level. Implications for drug development.
Clin Pharmacokinet. 1998 May;34(5):375-404. Review.
Dear Linda:Back to the Top
About renal clearance. There are many ways. One is based on a
24 hr urine specimen, or at least a carefully timed one, and a serum
creatinine measurement, usually taken about halfway through the
collection. There is also inulin clearance, and more recently with a
new version, sinistrin. Then there are the ways to estimate creatinine
clearance without a urine specimen, one by Jelliffe, another by
Cockcroft and Gault. They assume that serum creatinine is stable during
that time. It may take as long as a week for this to happen after a
change in renal function.
Another method you might consider is the one by our group that
is designed to handle unstable and changing serum creatinine values
from time to time, also without a urine specimen. It uses a pair of
serum creatinine values, and computes the creatinine clearance that
would make serum creatinine go from an initial value at a stated time
to a second value at another stated time, in a patient of a stated age,
gender, height, weight, and dialysis status. These have been described
Jelliffe RW: Estimation of Creatinine Clearance when Urine
Cannot be Collected. Lancet, 1: 975, 1971.
Jelliffe RW and Jelliffe SM: Estimation of Creatinine Clearance
from Changing Serum Creatinine Levels. Lancet II: p710,
Jelliffe RW and Jelliffe SM: A Computer Program for
Estimation of Creatinine Clearance from Unstable
SerumCreatinine Levels, Age, Sex, and Weight. Math
Biosci, 4: 17-24, 1972.
Jelliffe RW: Creatinine Clearance: Bedside Estimate. Ann
Int Med, 79: 604-605, 1973.
Jelliffe R: Estimation of Creatinine Clearance in Patients with
Unstable Renal Function, without a Urine Specimen.Am. J.
Nephrology, 22: 3200-324, 2002.
You might consider especially the most recent article in 2002.
We have used it in our USC*PACK PK software for many years now, and it
seems to do very well.
Very best regards,
Roger W. Jelliffe, M.D. Professor of Medicine,
Division of Geriatric Medicine,
Laboratory of Applied Pharmacokinetics,
USC Keck School of Medicine
2250 Alcazar St, Los Angeles CA 90033, USA
Phone (323)442-1300, fax (323)442-1302, email= jelliffe.-at-.usc.edu
Our web site=http://www.lapk.org
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