| Parameter | Range |
|---|---|
| CrCl (male) | 90-120 mL/min |
| CrCl (female) | 80-110 mL/min |
| Creatinine (male) | 0.7-1.3 mg/dL |
| Creatinine (female) | 0.5-1.1 mg/dL |
| Age-related decline | ~1 mL/min/yr after 40 |
| Stage | CrCl (mL/min) | Meaning |
|---|---|---|
| 1 | ≥90 | Normal (w/ kidney damage markers) |
| 2 | 60-89 | Mildly decreased |
| 3a | 45-59 | Mild-moderate decrease |
| 3b | 30-44 | Moderate-severe decrease |
| 4 | 15-29 | Severely decreased |
| 5 | <15 | Kidney failure / dialysis |
Morse, C. Y. (2023). Renal anatomy, physiology, pathophysiology, and anesthesia management. In S. Elisha, J. S. Heiner, & J. J. Nagelhout (Eds.), Nurse anesthesia (7th ed., pp. 742-769). Elsevier.
Creatinine clearance estimates glomerular filtration rate and guides dose adjustment for renally cleared drugs. The equation is CrCl (mL/min) = [(140 - age) x weight (kg)] / [72 x serum creatinine (mg/dL)], multiplied by 0.85 for female patients (Morse, 2023, p. 751). It estimates clearance rather than true GFR and overestimates in obese patients because it uses actual body weight. Normal is 90 to 120 mL/min in men and 80 to 110 mL/min in women (Morse, 2023, p. 753).
Renal clearance of drugs falls in proportion to GFR decline, prolonging duration of action (Morse, 2023, p. 760). Morphine needs a 50 to 75% reduction and is avoided in ESRD, pancuronium is avoided (80% renal excretion), and sugammadex is avoided if GFR is below 30, while fentanyl, remifentanil, and cisatracurium need little to no adjustment (Morse, 2023, pp. 760-762).
Morse, C. Y. (2023). Renal anatomy, physiology, pathophysiology, and anesthesia management. In Elisha, Heiner, & Nagelhout (Eds.), Nurse anesthesia (7th ed., pp. 742-769). Elsevier.