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Re: [NMusers] Allometric scaling of renal clearance with estimated glomerular filtration rate

From: Ruben Faelens <ruben.faelens_at_gmail.com>
Date: Tue, 05 Dec 2017 18:12:57 +0000

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_at_radboudumc.nl>:

> 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.
>


Received on Tue Dec 05 2017 - 13:12:57 EST

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