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Pediatric 
Creatinine Clearance Calculator
Utilizing Three Clearance Models
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Enter Data Below

Patient Name:    Room:
Age:      
Scr:     Height:

Background:

Program is based on the following equations:

Schwartz equation:      CrCl (ml/min/1.73m2)=  [length (cm) x k] / Scr
(Patient population: infants over 1 week old through adolescence (18 years old))
k = 0.45 for infants 1 to 52 weeks old
k = 0.55 for children 1 to 13 years old
k = 0.55 for adolescent females 13-18 years old
k = 0.7 for adolescent males 13-18 years old

Schwartz GJ, Haycock GB, Edelmann CM Jr, Spitzer A: A simple estimate of glomerular filtration rate in children derived from body length and plasma creatinine. Pediatrics 58:259-263, 1976.
Shull et al: Crcl (ml/min/1.73m2) = ((0.035 x age) + 0.236) x 100)/ Scr  

Shull BC, Haughey D, Koup JR, Baliah T, Li PK. A useful method for predicting creatinine clearance in children. Clin Chem. 1978 Jul;24(7):1167-9.
Counahan-Barratt: GFR (ml/min/1.73m2) = ( 0.43 x length )/ Scr

Counahan R, Chantler C, Ghazali S, Kirkwood B, Rose F, Barratt TM.  Estimation of glomerular filtration rate from plasma creatinine concentration in children. Arch Dis Child. 1976 Nov;51(11):875-8. 

Important Considerations:

Clinical application and reliability.  Several factors can reduce the accuracy of creatinine clearance predictive models such as concomitant disease states and medical procedures. The article below represents a common theme found in several other studies that examine the clinical utility of the various CRCL predictive models when complicating factors exist.

Jacobson P, West N, Hutchinson RJ.  Predictive ability of creatinine clearance estimate models in pediatric bone marrow transplant patients.  Bone Marrow Transplant. 1997 Mar;19(5):481-5. 
"In the majority of children, models overestimated CrCl. The tested models did not accurately predict CrCl and did not provide a reliable alternative to measured CrCl."   (Models assessed: Traub and Johnson, Schwartz et al, Counahan et al, modified Counahan et al, Ghazali and Barratt, Shull et al and Dechaux et al. )

Ideally a 24 hour urine collection and a mid-point serum creatinine  should be obtained. This method is the most accurate clinical measure of creatinine clearance.

The Schwartz method, like several other CRCL predictive models, attempts to estimate (not calculate) the creatinine clearance. It is important to remember that the result listed above should be considered a rough estimate of the CRCL.  Also, it is assumed that the serum creatinine is at steady state. If the patient's renal function is declining you must wait until steady state occurs or you will overestimate the clearance. The opposite occurs if the patient's renal function is improving. 


Counahan R, Chantler C, Ghazali S, Kirkwood B, Rose F, Barratt TM.  Estimation of glomerular filtration rate from plasma creatinine concentration in children. Arch Dis Child. 1976 Nov;51(11):875-8.  

Schwartz GJ, Haycock GB, Edelmann CM Jr, Spitzer A: A simple estimate of glomerular filtration rate in children derived from body length and plasma creatinine. Pediatrics 58:259-263, 1976.

Shull BC, Haughey D, Koup JR, Baliah T, Li PK. A useful method for predicting creatinine clearance in children. Clin Chem. 1978 Jul;24(7):1167-9.

Disclaimer

All calculations must be confirmed before use. The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical judgement. Neither GlobalRPh Inc. nor any other party involved in the preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material.PLEASE READ THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER.   Read the disclaimer
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