UNASSIGNED: The Cockcroft-Gault (CG) equation has become perhaps the most popular practical approach for estimating renal function among health care professionals. Despite its widespread use, clinicians often overlook not only the limitations of the original serum @entity1011 (SCr) based equation, but also may not appreciate the validity of the many variations used to compensate for these limitations. For cirrhotic @entity1 in particular, the underlying pathophysiology of the disease contributes to a falsely low SCr, thereby overestimating renal function with use of the CG equation in this population. We reviewed the original CG trial from 1976 along with data surrounding clinician specific alterations to the CG equation that followed through time. These alterations included different formulas for body weight in @entity28 @entity1 and the "rounding up" approach in @entity1 with low SCr. Additionally, we described the pathophysiology and hemodynamic changes that occur in @entity82 ; and reviewed several studies that attempted to estimate renal function in this population. The evidence we reviewed regarding the most accurate manipulation of the original CG equation to estimate @entity1011 clearance (CrCl) was inconclusive. Unfortunately, the homogeneity of the @entity1 population in the original CG trial limited its external validity. Elimination of body weight in the CG equation actually produced the estimate closest to the measure CrCl. Furthermore, "rounding up" of SCr values often underestimated CrCl. This approach could lead to suboptimal dosing of drug therapies in @entity1 with low SCr. In cirrhotic @entity1 , utilization of SCr based methods overestimated true renal function by about 50% in the literature we reviewed.

Cockcroft-Gault revisited: New de-liver-ance on recommendations for use in XXXX .

@entity1011 :: ('MESH:D003404', 'Chemical') :: ['creatinine'] @entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity82 :: ('MESH:D005355', 'Disease') :: ['cirrhosis'] @entity28 :: ('MESH:D009765', 'Disease') :: ['obese']
@entity82 :: (MESH:D005355,Disease) :: ['cirrhosis']
