 |
 |
In message <[log in to unmask] m>, "TICKNER TREVOR (RM1) Norfolk and Norwich NHS Trust" <[log in to unmask]> writes >The logic of using a creatinine clearance emulator intrigues me. > >The purpose of measurement of clearance is to direct a clinical management >decision. If an algorithm based on serum/plasma creatinine plus other data >such as sex can be used to emulate clearance and that is then used to direct >the decision, is not one actually using a sex/racial/weight 'corrected' >function of serum/plasma creatinine to define the action limits? > >Would it not, therefore, be more logical to seek direct rather than indirect >associations between serum/plasma creatinine concentration and outcome? > >Trevor Tickner, >Norwich It appears that this logic problem has been side-tracked by the whole pharmacological and pharmaceutical world as they seem to use the Cockcroft-Gault or versions almost exclusively in such areas as drug trialling. Perhaps it is because they know that collecting a timed urine correctly is one of the more taxing tasks in medicine. I assume that the results from the calculations have been demonstrated to match the drug excretion patterns they expect and/or vice-versa. Perhaps viewing it from a logical perspective both clearance and Cockcroft-Gault results are indirect associations of serum/plasma creatinine concentration anyway. -- Dr Henry Chandler