Renal Insufficiency, Chronic Clinical Trial
Official title:
How to Dose a Patient According to Renal Function? Glomerular Filtration Rate (GFR) or Creatinine Clearance (ClCr)
Background: The prevalence of chronic kidney disease (CKD) is high in Taiwan. Though there
are many factors that may affect the measurement of serum creatinine, it is a well-accepted
marker for renal function assessment. The creatinine clearance (ClCr) estimated by
Cockcroft-Gault is commonly used as a reference for dosage adjustment; while the estimated
glomerular filtration rate (eGFR) by Modification of Diet in Renal Disease (MDRD) is used in
CKD staging. ClCr and eGFR not only have different units, but the results of estimation from
the two varied among races and individuals. Since 2010, US Food and Drug Administration
required both the influences of ClCr and eGFR on the pharmacokinetics of a drug in renal
insufficient patients during pharmacokinetic studies. Because most drugs are excreted
through kidney, an understanding on the relationship between ClCr and eGFR is important to
dose safely and effectively. Furthermore, identifying the factors that may influence the
difference between ClCr and eGFR can provide in-depth consideration during clinical renal
function assessment.
Purpose: The purpose of this study is to analyze the correlation between different ClCr and
eGFR equations in order to provide better renal dose. We also want to find the factors that
may cause the differences between them.
Methods: This study will conduct literature review to understand study population during the
development of different ClCr and eGFR equations, as well as their scope of application.
National Taiwan University Hospital electronic patient database will be used to analyze the
correlation between ClCr and eGFR and to identify factors that may influence the difference
between ClCr and eGFR. The data from patients who have completed 12-hr or 24-hr urine
collection with calculated renal function will be used to verify the applicability of these
equations (including a ClCr equation developed by our institute) in Taiwanese.
Pharmacokinetic principles will be used to analyze the appropriate unit to be used for renal
function while dosing a patient.
n/a
Observational Model: Cohort, Time Perspective: Cross-Sectional
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