No role for patient body weight on renal function assessment for drug dosing

Ariano, Robert E.; Zelenitsky, Sheryl; Poncsak, Kristen R.; Davis, Jane; Vercaigne, Lavern M.

doi:10.1093/jac/dkx036

Cited by 3 publications

(1 citation statement)

References 51 publications

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“…The physiological max GFR is approximately 120 mL/min; however, if the total body weight of an obese patient is entered into the equation the resultant value for CrCl often exceeds this threshold [ 9 – 11 ]. The question arises as to whether we should use ideal, lean, adjusted, or total body weight; a question that has been frequently tested with different answers [ 9 – 14 ]. The original Cockcroft-Gault equation suggested total body weight – but this was before the worldwide obesity epidemic.…”

Section: Introductionmentioning

confidence: 99%

Evaluation and enhancement of standard equations for renal function estimation in individuals with components of metabolic disease

Brunetti

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et al. 2021

BMC Nephrol

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Background The primary objective of this study aims to test patient factors, with a focus on cardiometabolic disease, influencing the performance of the Cockcroft-Gault equation in estimating glomerular filtration rate. Methods A cohort study was performed using data from adult patients with both a 24-h urine creatinine collection and a serum creatinine available. Creatinine clearance was calculated for each patient using the Cockcroft-Gault, Modified Diet in Renal Disease, and Chronic Kidney Disease Epidemiology Collaboration equations and estimates were compared to the measured 24-h urine creatinine clearance. In addition, new prediction equations were developed. Results In the overall study population (n = 484), 44.2% of patients were obese, 44.0% had diabetes, and 30.8% had dyslipidemia. A multivariable model which incorporating patient characteristics performed the best in terms of correlation to measured 24-h urine creatinine clearance, accuracy, and error. The modified Cockcroft-Gault equation using lean body weight performed best in the overall population, the obese subgroup, and the dyslipidemia subgroup in terms of strength of correlation, mean bias, and accuracy. Conclusions Regardless of strategy used to calculate creatinine clearance, residual error was present suggesting novel methods for estimating glomerular filtration rate are urgently needed.

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Section: Introductionmentioning

confidence: 99%

Evaluation and enhancement of standard equations for renal function estimation in individuals with components of metabolic disease

Brunetti

Back

et al. 2021

BMC Nephrol

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Evaluation of cefazolin antimicrobial prophylaxis during cardiac surgery with cardiopulmonary bypass

Calic

Ariano

Arora

et al. 2017

Journal of Antimicrobial Chemotherapy

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Antimicrobial Prophylaxis for Patients Undergoing Cardiac Surgery: Intraoperative Cefazolin Concentrations and Sternal Wound Infections

Zelenitsky

Calic

Arora

et al. 2018

Antimicrob Agents Chemother

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This study characterizes the pharmacodynamics of antimicrobial prophylaxis and sternal wound infections following cardiac surgery. Duration of surgery and cefazolin plasma concentration during wound closure were independently associated with surgical site infection at 30 days. Furthermore, a duration of surgery of >346 min and a total cefazolin closure concentration of <104 mg/liter were significant thresholds for an increased risk of infection. This study provides new data that informs dosing strategies for effective antimicrobial prophylaxis (AP) in patients undergoing cardiac surgery with cardiopulmonary bypass.

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No role for patient body weight on renal function assessment for drug dosing

Abstract: Based on the use of gentamicin as a surrogate guide for renally adjusted drugs, these results support dosing interval selection based on a normalized body weight method and a formula reagent adjustment factor of 90% within the Cockcroft-Gault formula.

Cited by 3 publications

References 51 publications

Evaluation and enhancement of standard equations for renal function estimation in individuals with components of metabolic disease

Evaluation and enhancement of standard equations for renal function estimation in individuals with components of metabolic disease

Evaluation of cefazolin antimicrobial prophylaxis during cardiac surgery with cardiopulmonary bypass

Antimicrobial Prophylaxis for Patients Undergoing Cardiac Surgery: Intraoperative Cefazolin Concentrations and Sternal Wound Infections

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