creatinine clearance

[ykw]

is creatinine clearance in the unit of ml/minute/1.73 m2 the same as that with the unit of ml/minute? eg. when doing dosage adjustment in a child with creatinine clearance of 50 ml/min/1.73 m2, shall we refer to the recommendation under 50 ml/min?

[paul2008]

is creatinine clearance in the unit of ml/minute/1.73 m2 the same as that with the unit of ml/minute? eg. when doing dosage adjustment in a child with creatinine clearance of 50 ml/min/1.73 m2, shall we refer to the recommendation under 50 ml/min?

Unfortunately the eGFR measured per 1.73m2 bears no relation to the patients actual GFR unless you calculate the body surface area and convert it. You are best calculating the estimated GFR using an equation like the Cockcoft and Gault equation as almost all trials are based on this and the BNF and renal handbook doses are based on this equation, however the BNF online has an eGFR calculator now so I'm not sure what will be used in the future.

[paul2008]

Update: The new BNF and the updated 3rd edition renal hand book suggest using eGFR calculated by the MDRD formular units mls/min/1.73m2 except for patients with BMI less than 18.5 or greater than 28 then to calculate absolute GFR (eGFR x BSA/1.73) or use Cockcroft and Gault. Reference values are being updated. eGFR should also not be used for children and adolescents. In other words the eGFR is a good estimate for patients of average build and weight.

Looks like uneccesary complication. I don't see how this will improve dosing in renal impairment but its the latest fashion.