![]() Stevens LA, Nolin TD, Richardson MM, et al.Kidney function estimating equations: where do we stand? Curr Opin Nephrol Hypertens. Prediction of creatinine clearance from serum creatinine. With permission from The National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892-2560. ![]() However, for drugs with a narrow therapeutic index, the Cockcroft-Gault equation was less reliable in assessing the risk of kidney damage. The results suggested that, for the majority of patients and for most drugs tested that did not have narrow thresholds for toxicity, there was little difference in the drug dose that would be administered using either equation to estimate kidney function. A large simulation study compared eGFR by MDRD Study equation and estimated creatinine clearance (eCrCl) by the Cockcroft-Gault equation calculated from standardized creatinine values to each other and to measured GFR for the purpose of drug dosing.There is no version of the Cockcroft Gault equation for use with standardized creatinine results.Unfortunately, the creatinine method used in the development of the Cockcroft-Gault equation is no longer in use and samples from the study are not available to evaluate how the results might compare to standardized creatinine values. Creatinine measurement has now been standardized.Is there a role for the Cockcroft-Gault equation? Since the Cockcroft-Gault can overestimate kidney function, there is a risk of overdosing drugs with narrow therapeutic index that has occurred with chemotherapeutic agents.įor more information, see.One study of inpatients receiving aminoglycoside or vancomycin compared the area under the curve for actual drug levels to the eGFR and showed greater precision for the MDRD Study equation. In the few studies that compared estimated GFR from the various equations to measured GFR, the studies have shown that the MDRD Study or CKD-EPI equation had greater concordance with measured GFR than the Cockcroft-Gault. Multiple studies have compared the equations for their impact on drug dosages.The assay used to develop the Cockcroft-Gault was likely 10-20% higher than current methods, therefore use of estimated creatinine clearance calculated using the Cockcroft-Gault will lead to higher drug dosing recommendations than was intended in the original pharmacokinetic studies. Both the MDRD Study and CKD-EPI have been expressed for these reference methods, but the Cockcroft-Gault formula has not. Creatinine assays are standardized to reference methods.This means it will give inaccurate results. The Cockcroft-Gault (CG) formula has not been expressed using standardized creatinine values.Why isn’t the Cockcroft-Gault formula recommended for clinical use? Both have been shown to be more accurate than the CG formula. The best way to determine drug dosing is with the CKD-EPI Creatinine Equation (2009) or the MDRD Study.It should not be used for drug dosing or to estimate GFR. The Cockcroft-Gault (CG) formula is provided on this website for research purposes only.SCr (serum creatinine) = mg/dL Why is the Cockcroft-Gault formula provided on this website? Calculate Results The Cockcroft and Gault formula (1973)Īdditional information The Cockcroft and Gault formula (1973)Ĭ Cr=x 0.85 (if female) Abbreviations/ Units
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