估计使用肌素,囊素C或两者的GFR以及对预测万科米辛半衰期的影响
Amanda Dobson1,2, Robert MacLaren3, Shelby Pons1
1Department of Pharmacy, UCHealth University of Colorado Hospital, Aurora, CO, USA.
The Annals of pharmacotherapy
|December 29, 2025
概括
使用不同的方程估计膜过率 (GFR) 会导致预测万科米辛半衰期的显著变化,影响药物剂量. 临床医生应考虑所选择的GFR方程,以确保万科米辛的准确管理.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 药理动力学 药理动力学
- 关键护理医学 关键护理医学
背景情况:
- 估计淋巴膜过率 (GFR) 对于药物剂量至关重要,通常使用肌素,囊素C或组合方程.
- 在GFR估计中的差异可能导致药物剂量调整的显著变化.
研究的目的:
- 为了比较来自四个常见方程的GFR估计值:Cockcroft-Gault (CrClCG),CKD-EPI肌 (eGFRcr),CKD-EPI肌C (eGFRcys) 和CKD-EPI肌-肌C (eGFRcr-cys).
- 评估这些GFR估计之间的相关性.
- 为了确定不同的GFR估计对预测万科米辛半衰期 (t1/2) 的影响.
主要方法:
- 重症患者成年人的回顾性队列研究.
- 使用CrClCG,eGFRcr,eGFRcys和eGFRcr-cys估计的GFR.
- 统计分析包括MANOVA和皮尔森相关系数 (r2).
- 贝叶斯模型预测了万科米辛t1/2.2.
主要成果:
- 在四个方程中平均GFR的显著差异 (P < 0.0001).
- 在方程之间观察到的中度至强度的相关性 (r2值在0.54到0.92之间)
- 基于GFR估计方法的预测万科米辛t1/2 (范围为33.3至43.2小时) 的实质性变化.
- 在更高的GFR中,差异更明显.
结论:
- GFR估计方法的结果差异很大,特别是基于肌素的方程产生更高的值.
- 这些GFR差异导致了预测万科米辛半衰期的显著差异.
- 意识到GFR估计方法的变化对于准确的万科米辛剂量和临床决策至关重要.
相关概念视频
01:28Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration
166
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.
166
01:25Drug Dosing in Renal Diseases: Measurement of Serum Creatinine Concentration and Clearance
165
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...
165
01:17Factors Affecting Renal Clearance: Renal Impairment
399
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...
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...
399
01:20Estimation of k and VD of Aminoglycosides
191
Aminoglycosides are a class of antibiotics used to treat various bacterial infections. Clinicians must determine the elimination rate constant (k) and volume of distribution (VD) to optimize therapeutic efficacy and minimize toxicity. The k value represents the rate at which the drug is removed from the body, and the VD reflects the degree to which the drug distributes into body tissues. Accurately estimating these parameters allows healthcare professionals to tailor drug dosing to individual...
191
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
216
In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
216
01:23Renal Clearance
2.3K
The glomerular filtration rate (GFR) is a critical marker of kidney function, reflecting the efficiency of filtration by the glomeruli. Renal clearance of specific substances, such as inulin or creatinine, is commonly used to measure GFR.
Renal clearance refers to the volume of plasma cleared of a specific substance, such as creatinine, per unit of time. To measure clearance, urine samples are collected over a 24-hour period during each bladder voiding, followed by a single blood sample at the...
Renal clearance refers to the volume of plasma cleared of a specific substance, such as creatinine, per unit of time. To measure clearance, urine samples are collected over a 24-hour period during each bladder voiding, followed by a single blood sample at the...
2.3K