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Related Concept Videos

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...
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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...
Continuous Renal Replacement Therapy01:30

Continuous Renal Replacement Therapy

Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
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...
Chronic Kidney Disease IV: Nursing Management01:18

Chronic Kidney Disease IV: Nursing Management

Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care​.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of fluid...

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Related Experiment Video

Updated: May 21, 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

Monitoring renal function during chemotherapy.

Louise B Hartlev1, Charlotte R Boeje, Henrik Bluhme

  • 1Department of Nuclear Medicine, Aarhus University Hospital, Brendstrupgaardsvej 100, 8200 Aarhus N, Denmark.

European Journal of Nuclear Medicine and Molecular Imaging
|June 16, 2012
PubMed
Summary

Estimated glomerular filtration rate (eGFR) using the MDRD equation is unreliable for monitoring renal function in cancer patients undergoing chemotherapy. Actual GFR measurements are crucial for adjusting nephrotoxic drug doses to avoid under- or over-treatment.

Related Experiment Videos

Last Updated: May 21, 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

Area of Science:

  • Nephrology
  • Oncology
  • Pharmacology

Background:

  • Renal function monitoring is vital during chemotherapy due to potential kidney toxicity of drugs.
  • Chemotherapeutic drug doses are adjusted based on glomerular filtration rate (GFR) to ensure efficacy and safety.
  • Plasma clearance of (51)Cr-EDTA is a reliable GFR measure but is costly; estimated GFR (eGFR) using formulas like MDRD is an alternative.

Purpose of the Study:

  • To evaluate the reliability of MDRD-based eGFR in detecting changes in actual GFR.
  • To assess if eGFR can accurately reflect GFR alterations in cancer patients receiving nephrotoxic chemotherapy.
  • To determine if eGFR is a suitable replacement for (51)Cr-EDTA GFR measurements in this patient population.

Main Methods:

  • Study included oncology patients undergoing chemotherapy with at least four GFR measurements via (51)Cr-EDTA plasma clearance over 12 months.
  • Estimated GFR (eGFR) was calculated using the MDRD formula based on plasma creatinine concentration.
  • Actual GFR was determined using the (51)Cr-EDTA plasma clearance technique.

Main Results:

  • A significant decrease in actual GFR was observed from 86 to 73 ml/min/1.73 m(2) (p < 0.002) over the study period.
  • Plasma creatinine concentration and MDRD-based eGFR remained unchanged in the patient cohort.
  • In 27% of patients, decreased GFR necessitated chemotherapy dose adjustments; however, five patients with reduced GFR had normal eGFR, indicating a risk of inappropriate dosing.

Conclusions:

  • MDRD-based eGFR is not a reliable substitute for (51)Cr-EDTA plasma clearance for monitoring GFR in cancer patients on nephrotoxic chemotherapy.
  • Creatinine concentration and eGFR (MDRD) may fail to detect significant GFR declines, potentially leading to incorrect chemotherapy dosing.
  • Accurate GFR measurement using (51)Cr-EDTA remains essential for safe and effective management of patients receiving nephrotoxic chemotherapeutic agents.