Re: Allometric scaling of renal clearance with estimated glomerular filtration rate
Dear Rob,
At PMX Benelux, there was an interesting talk about the correlation between
different metrics describing renal function by Stijn Jonckheere.
A part of the work presented was published:
https://academic.oup.com/jac/article/71/9/2538/1750427
This may provide some perspective, or rather complicate things even more,
depending on your viewpoint.
Best regards
Ruben Faelens
Op di 5 dec. 2017 18:24 schreef <R.terHeine
> Dear all,
>
>
>
> I am wondering what your thoughts are on the allometric scaling of
> clearance of renally extreted drugs, where we have estimations renal
> function.
>
>
>
> Simply scaling the predicted glomerular filtration rate from, for example,
> the Cockroft-gault equation seems inappropriate, since weight is already a
> part of the equation. Standardizing this to weight in the Cockroft-gault
> equation can be done, a solution has been discussed here:
> http://cognigencorp.com/nonmem/current/2013-August/4697.html
>
>
>
> However, in the recent years some new equations to calculate glomerular
> filtration rate from endogenous markers have emerged. For example the
> CKD-EPI CREATININE CYSTATIN C equation
> https://www.kidney.org/content/ckd-epi-creatinine-cystatin-equation-2012
> . As the addition of a muscle mass independent endogenous marker like
> cystatin C is known to provide better estimations of GFR in, for example,
> cachectic patients, it is likely that this equation may outperform to
> predict renally filtrated compounds in this patient group. It is rather odd
> that this CKD-EPI equation does not contain any measure of body size. The
> outcome of this equation is a GFR scaled to a BSA of 1.73m^2.
>
>
>
> I am wondering how you would allometrically scale the eGFRs from these CKD
> EPI equations to, for example, fat-free mass.
>
>
>
> Cheers!
>
> Rob
>
>
>
> R. ter Heine, PhD, PharmD
>
> Hospital Pharmacist-Clinical Pharmacologist
>
> Radboudumc, Nijmegen, The Netherlands
>
>
>
> Het Radboudumc staat geregistreerd bij de Kamer van Koophandel in het
> handelsregister onder nummer 41055629.
> The Radboud university medical center is listed in the Commercial Register
> of the Chamber of Commerce under file number 41055629.
>