Renal Clearance – Elimination Kinetics

by Pravin Shukle, MD

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    Let's talk about renal clearance. Now, renal clearance is the rate of excretion in the urine divided by the plasma concentration. So you can see here that the kidneys are going to be very very important in eliminating most of our drugs. Now, we use something called the Cockroft-Gault Formula. So this guy, his name is Donald Cockroft. He is actually a professor at my old university. And what's interesting is, is that when he was a resident, he came up with part of the formula along with his supervising professor. What's really interesting about this guy, aside from being the nicest guy in the world, and a real gem of a person, is that he is actually a respirologist by trade, and he would frequently go over to the nephrologist and torment them and say "How was my formula doing?" So, there was a lot of fun working with him when I was doing my respiratory rotation. Anyway, let's get on to that formula. The formula was calculated out using the creatinine value, as 140 minus the age, times the weight in kilos, divided by the creatinine. That's using the matric numbers. Using the non-matric or standard US numbers, you just have to multiply it in the denominator by 72. Now in women, we do have a correction factor of 0.85. Let's do a case study, and we'll correct for renal disease. William is a 68 year old patient with schizophrenia. His psychiatrist prescribes lithium. The following are the pharmacokinetic parameters. It is a fully bioavailable drug. Okay. The drug is 100% renally excreted with the clearance of 1.8 litres/hour. And these are the other parameters that I have got listed there. What would be the required loading dose for this patient? Let's go through the formula. The loading...

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    The lecture Renal Clearance – Elimination Kinetics by Pravin Shukle, MD is from the course Pharmacokinetics and Pharmacodynamics.

    Author of lecture Renal Clearance – Elimination Kinetics

     Pravin Shukle, MD

    Pravin Shukle, MD

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