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Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration01:28

Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration

Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area. This equation is...
Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant01:25

Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant

In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
Drug Dosing in Renal Diseases: Measurement of Serum Creatinine Concentration and Clearance01:25

Drug Dosing in Renal Diseases: Measurement of Serum Creatinine Concentration and Clearance

In healthy individuals, serum creatinine levels remain stable due to a balance between its constant production—primarily from muscle metabolism—and renal excretion. Creatinine is freely filtered by the glomeruli, making it a valuable marker for estimating renal function. When the glomerular filtration rate (GFR) decreases, the kidneys can only eliminate less creatinine, causing serum levels to rise.Serum creatinine concentration is widely used to estimate creatinine clearance (Clcr), a...
Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate01:25

Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate

The glomerular filtration rate (GFR) is a critical indicator of kidney health, reflecting how well the kidneys filter blood. Changes in GFR can signal potential kidney impairment, necessitating accurate measurement methods to monitor kidney function effectively.Various molecules can serve as markers for GFR measurement, with the ideal marker meeting several specific criteria. It must freely filter at the glomerulus, avoid reabsorption or secretion by the renal tubules, remain unmetabolized, not...
Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Factors Affecting Renal Clearance: Renal Impairment01:17

Factors Affecting Renal Clearance: Renal Impairment

Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...

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Updated: Jun 27, 2026

Early Detection of Drug-Induced Renal Hemodynamic Dysfunction Using Sonographic Technology in Rats
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Early Detection of Drug-Induced Renal Hemodynamic Dysfunction Using Sonographic Technology in Rats

Published on: March 11, 2016

[Renal function estimation by MDRD equation: interest and limitations for drug dosing].

Françoise Livio1, Jérôme Biollaz, Michel Burnier

  • 1Division de pharmacologie et toxicologie cliniques, CHUV, 1011 Lausanne. francoise.livio@chuv.ch

Revue Medicale Suisse
|December 11, 2008
PubMed
Summary

The Modification of Diet in Renal Disease (MDRD) equation estimates kidney function using serum creatinine, aiding in renal failure detection. While more reliable than Cockcroft-Gault for low GFR, it underestimates normal function and requires adjustments for drug dosing.

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Physiology Lab Demonstration: Glomerular Filtration Rate in a Rat
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Physiology Lab Demonstration: Glomerular Filtration Rate in a Rat

Published on: July 26, 2015

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Last Updated: Jun 27, 2026

Early Detection of Drug-Induced Renal Hemodynamic Dysfunction Using Sonographic Technology in Rats
06:38

Early Detection of Drug-Induced Renal Hemodynamic Dysfunction Using Sonographic Technology in Rats

Published on: March 11, 2016

Physiology Lab Demonstration: Glomerular Filtration Rate in a Rat
06:58

Physiology Lab Demonstration: Glomerular Filtration Rate in a Rat

Published on: July 26, 2015

Area of Science:

  • Nephrology
  • Clinical Chemistry

Context:

  • Serum creatinine is a key biomarker for assessing kidney function.
  • Glomerular filtration rate (GFR) estimation is crucial for diagnosing and managing renal diseases.
  • The Modification of Diet in Renal Disease (MDRD) equation is widely used for GFR estimation.

Purpose:

  • To evaluate the performance and utility of the MDRD equation for estimating GFR.
  • To compare the MDRD equation with the Cockcroft-Gault (C-G) formula.
  • To assess the implications of MDRD-estimated GFR (eGFR) for clinical practice, including drug dosing.

Summary:

  • The MDRD equation estimates GFR using serum creatinine, facilitating early recognition of renal failure.
  • Its predictive performance is superior for GFR < 60 ml/min/1.73 m², but it tends to underestimate normal or near-normal renal function.
  • While generally more reliable than the C-G formula, both equations have limitations in precision, and MDRD requires body surface area adjustment for accurate drug dosing.

Impact:

  • Increased recognition of chronic kidney disease through routine eGFR reporting.
  • Highlights the need for careful interpretation of MDRD eGFR in patients with normal or near-normal kidney function.
  • Informs clinical decision-making regarding drug dosages, emphasizing the necessity of body surface area adjustments for MDRD eGFR.