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The Cockroft and Gault formula for estimation of creatinine clearance: a friendly deconstruction
1Medical Department, Southland Hospital, Invercargill, New Zealand. Alasdair.millar@health.wa.gov.au
Aims:
To review the derivation of the Cockroft and Gault formula for estimating creatinine clearance from serum creatinine in a historical context.
Method:
The derivation described by Cockroft and Gault was reviewed, and an alternative formula was sought using the data reported in the paper.
Results:
Cockroft and Gault used 24 hour urine creatinine data expressed as mg/kg body weight and mathematical manipulation of a linear regression equation which introduced body weight as an independent variable into the formula. This involved a circular logic and may have been mathematically invalid. A more logical equation not containing body weight was derived from the data.
Conclusion:
The Cockcroft and Gault formula has been validated by long usage but the derivation appears logically insecure. Nevertheless, its role in estimating renal function at the bedside is established.
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