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Serum creatinine is a product of creatine metabolism from _________.
muscle

Serum creatinine is eliminated primarily by ____________.
glomerular filtration

Thus, SCr and GFR are ________related.
 Inversely
 When GFR increases, SCr decreases and vice versa

_________________ alone should NOT be used to assess the level of kidney function.
SCr concentration

(True/False) SCr can be influenced by many factors.
True

What factors decrease SCr by Reducing creatinine generation, particularly in children, women, elderly, malnourished pts?
Reduced muscle mass

What factors increase SCr by transient increase in creatinine generation?
Ingestion of cooked meat

What factors decrease SCr by reducing creatinine generation through mechanisms of reduced muscle mass and reduced meat intake?
Malnutrition

What factors can increase SCr by Inhibition of tubular creatinine secretion?
Use of cimetidine, trimethoprim, probenecid

What factors can increase SCr by interference with assays for creatinine
Use of flucytosine, some cephalosporins

What factors can increase SCr by interference with assays for creatinine
Ketoacidosis

What are the reasons you might want to obtain a 24 hour urine sample to obtain a directly measured CrCl value (rather than using prediction equations)?
 Extremes of age and body size (variable muscle mass)
 Severe malnutrition or obesity (variable muscle mass)
 Disease of the skeletal muscle (variable muscle mass)
 Paraplegia or quadriplegia (variable muscle mass)
 Vegetarian diet (variable muscle mass)
 Rapidly changing renal function
 Prior to dosing drugs with significant toxicity that is excreted by the kidneys

Equations for the estimation of GFR and CrCl (CG, MDRD, CKDEPI) rely on what patient parameters?
Individual having stable renal function/steady state

What is the CockcroftGault equation?
 Men: CLCr =(140age)ActBW/(SCr x 72)
 Women: CLCr x 0.85

The CKDEPI equation was validated inw hat group of patients?
Those with a GFR over 60

What equations can be used to obtain eCrCl?
 CG
 Jeliffe
 Brater
 SalazarCorcoran
 Schwartz

What equations can be used to obtain eGFR?

What are the standard units for CrCl?
mL/min

What is a normal CrCl for a male?
97 to 137 ml/min

What is a normal CrCl for a Female?
88 to 128 ml/min

What is a normal CrCl for Newborns (1 day)?
550 mL/min/1.73m2

What is a normal CrCl for a Newborns (6 days)?
1590 mL/min/1.73m2

What does the FDA classify as normal renal function?
> or = to 90

When should you use adjusted body weight instead of actual body weight?
When a patient weighs more than 20% of their IBW

What is the Ideal Body Weight (IBW) equation for Males
= 50 kg + 2.3 (inches over 5 ft tall)

What is the Ideal Body Weight (IBW) equation for Females?
= 45.5 kg + 2.3 (inches over 5 ft tall)

What is the Adjusted Body Weight (AdjBW) equation?
[0.4 x (ActBW – IBW)] + IBW

Should you round up to 1 when elderly patients have a CrCl of <1?
No, less biased to use actual number

What does MDRD Stand for?
Modification of Diet in Renal Disease

FDA currently supports using which equations for estimating renal function for dosing of medications?
 MDRD or the CG
 However, the MDRD equation has never been validated in large clinical trials to dose lovenox

What is the SalazarCorcoran used for?
Has been validated for morbidly obese

What equation has been validated in patients with CKD and GFR over 60 mL/min/1.73m2?
CKDEPI equation

What does CKDEPI stand for?
Chronic Kidney Disease Epidemiology Collaboration Equation

CKDEPI equation is more accurate than ________ for values >60 mL/min/1.73m2
MDRD

How could you use the CG equation for estimating renal function in a patient with acute kidney injury/rapidly changing function?
Use the highest possible SCr value you could obtain

Brater and Jelliffe equations use ____________values.
age, weight, two SCr, the days in between those SCr values

What equation should you use to estimate kidney function in a liver disease patient?
Equations overestimate = draw a direct measurement of GFR

What equation should you use to estimate kidney function in a pediatric?
Schwartz (FDA supported)

_________is the primary endogenous biomarker.
SCr

