Bethany A Lessard1, Kathy Zaiken. 1. Steward Health Care Network, Dedham, MA 02026, USA. bethany.lessard@steward.org
Abstract
OBJECTIVE: To compare the Cockcroft-Gault (CG) and Modification of Diet in Renal Disease (MDRD) equations for renal dosing of medications in primary care patients. METHODS: Patients with stages 3, 4, or 5 chronic kidney disease who had been prescribed one of the renally cleared study medications during a 16-month time period were identified. The appropriate dose of patients' study medications, based on their most recent creatinine clearance (CrCl) and estimated glomerular filtration rate (eGFR), was determined. The primary outcome was the rate in which the CG and MDRD equations provided the same dosing recommendation. RESULTS: The rate at which the CG ideal body weight and MDRD equations recommended the same dose was 59.6% (P = 0.001). The rate at which the CG actual body weight and MDRD equations recommended the same dose was 71.1% ( P = 0.001). CONCLUSION: A significant difference exists in the doses derived from the CG and MDRD equations in the primary care setting. CG should continue to be used for renal dosing until further recommendations are available.
OBJECTIVE: To compare the Cockcroft-Gault (CG) and Modification of Diet in Renal Disease (MDRD) equations for renal dosing of medications in primary care patients. METHODS:Patients with stages 3, 4, or 5 chronic kidney disease who had been prescribed one of the renally cleared study medications during a 16-month time period were identified. The appropriate dose of patients' study medications, based on their most recent creatinine clearance (CrCl) and estimated glomerular filtration rate (eGFR), was determined. The primary outcome was the rate in which the CG and MDRD equations provided the same dosing recommendation. RESULTS: The rate at which the CG ideal body weight and MDRD equations recommended the same dose was 59.6% (P = 0.001). The rate at which the CG actual body weight and MDRD equations recommended the same dose was 71.1% ( P = 0.001). CONCLUSION: A significant difference exists in the doses derived from the CG and MDRD equations in the primary care setting. CG should continue to be used for renal dosing until further recommendations are available.