Pharmacotherapy

Study finds high discordance among eGFR calculations in critically ill patients

February 20, 2025

Study details: This single-center, retrospective, observational cohort study included 232 critically ill adult patients with both serum creatinine (SCr) and cystatin C (cysC) levels measured. The study aimed to determine the discordance rate in estimated glomerular filtration rate (eGFR) between SCr-based calculations and SCr/cysC-based calculations affecting drug dosing.

Results: There was a significant discordance rate of 32.3% in eGFR calculations between the two methods. Median clearance rates were 68.5 mL/min for Cockcroft-Gault (CG) and 53.9 mL/min for CKD-EPI eGFRcr-cys (p < 0.001). The most common drugs showing discordance were cefepime (40.6%), vancomycin (38.3%), levetiracetam (35.1%), and piperacillin/tazobactam (11.6%).

Clinical impact: The findings underscore the importance of considering both SCr and cysC in eGFR calculations for critically ill patients to ensure accurate drug dosing. This could potentially reduce the risk of medication-related adverse events and improve patient outcomes.

Source:

Williams VL, Gerlach AT. (2025, February 13). Pharmacotherapy. Establishing discordance rate of estimated glomerular filtration rate between serum creatinine-based calculations and cystatin-C-based calculations in critically ill patients.https://pubmed.ncbi.nlm.nih.gov/39945448/