Related Experiment Video
Updated: Apr 4, 2026
05:34
5/6 Nephrectomy Using Sharp Bipolectomy Via Midline Laparotomy in Rats
Published on: April 4, 2025
1.9K
Influence of Kidney Function Estimation Methods on Carboplatin Dosing and Clinical Outcomes
Omar El Khatib1, Sara Zekery-Saad1, Emna Abidi1
1Department of Pharmacy Services, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.
The Annals of Pharmacotherapy
|April 3, 2026
Summary
Carboplatin dosing varies significantly based on the kidney function equation used. Standardized guidelines are urgently needed to ensure patient safety and optimal treatment outcomes.
Area of Science:
- Oncology
- Nephrology
- Pharmacokinetics
Background:
- The Calvert formula is standard for carboplatin dosing, but kidney function estimation methods vary.
- Conflicting recommendations exist between oncology and nephrology guidelines regarding kidney function assessment.
Purpose of the Study:
- To compare actual carboplatin doses with those estimated using different kidney function equations.
- To evaluate the clinical impact of dose variations resulting from different estimation methods.
Main Methods:
- Retrospective chart review of adult patients receiving carboplatin (May 2015-March 2024).
- Carboplatin doses were estimated using the Calvert formula with multiple kidney function equations.
- Estimated doses were compared to actual administered doses.
Main Results:
- Significant variability in estimated kidney function and carboplatin doses across equations (e.g., Cockcroft-Gault, CKD-EPI, Janowitz).
- Higher rates of hematologic toxicity, including febrile neutropenia, observed with carboplatin doses calculated using the Cockcroft-Gault equation with actual body weight compared to adjusted body weight.
Conclusions:
- Kidney function estimation method critically impacts carboplatin dosing.
- Urgent need for standardized, interdisciplinary guidelines for carboplatin dosing to improve patient safety and treatment efficacy.
Related Concept Videos
01:25Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant
315
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...
315
01:28Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration
308
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.
308
01:25Drug Dosing in Renal Diseases: Measurement of Serum Creatinine Concentration and Clearance
347
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...
347
01:11Renal Failure: Dose Adjustments
583
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...
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...
583
01:08Renal Drug Clearance: Comparison Between Renal Excretion Methods
784
Renal clearance is a critical parameter encompassing kidney filtration, secretion, and reabsorption processes. It is calculated using a specific equation to determine the rate at which the kidneys clear a drug.
Renal clearance is often associated with the renal glomerular filtration rate (GFR), which represents the rate at which plasma is filtered through the glomeruli in the kidney. When drug reabsorption is minimal and there is no active secretion, renal clearance is closely related to the...
Renal clearance is often associated with the renal glomerular filtration rate (GFR), which represents the rate at which plasma is filtered through the glomeruli in the kidney. When drug reabsorption is minimal and there is no active secretion, renal clearance is closely related to the...
784
01:25Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate
107
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...
107