calc_egfr {clinPK}R Documentation

Calculate eGFR

Description

Calculate the estimated glomerular filtration rate (an indicator of renal function) based on measured serum creatinine using one of the following approaches:

Equations for estimation of eGFR from Cystatin C concentrations are available from the 'calc_egfr_cystatin()' function.

Usage

calc_egfr(
  method = "cockcroft_gault",
  sex = NULL,
  age = NULL,
  scr = NULL,
  scr_unit = NULL,
  race = "other",
  weight = NULL,
  height = NULL,
  bsa = NULL,
  preterm = FALSE,
  ckd = FALSE,
  times = NULL,
  bsa_method = "dubois",
  relative = NULL,
  unit_out = "mL/min",
  verbose = TRUE,
  min_value = NULL,
  max_value = NULL,
  fail = TRUE,
  ...
)

egfr_wright(age, bsa, sex, scr)

egfr_jelliffe(age, sex, bsa, scr)

egfr_jelliffe_unstable(weight, times, scr, age, sex)

egfr_mdrd(sex, race, scr, age, use_race, original_expression)

egfr_ckd_epi(sex, race, scr, age, use_race)

egfr_ckd_epi_as_2021(sex, scr, age)

egfr_cockcroft_gault_sci(sex, age, scr, weight)

egfr_cockcroft_gault(sex, age, scr, weight)

egfr_malmo_lund(sex, age, scr)

egfr_bedside_schwartz(age, height, scr, verbose)

egfr_schwartz(age, preterm, sex, height, scr)

Arguments

method

eGFR estimation method, choose from 'cockcroft_gault', 'cockcroft_gault_ideal', 'cockcroft_gault_adjusted', 'cockcroft_gault_adaptive', 'mdrd', 'mdrd_ignore_race', 'mdrd_original', 'mdrd_original_ignore_race', 'ckd_epi', 'ckd_epi_ignore_race', 'ckd_epi_as_2021', 'malmo_lund_revised', 'schwartz', 'jelliffe', 'jellife_unstable', 'wright'.

sex

sex

age

age, in years

scr

serum creatinine (mg/dL)

scr_unit

'mg/dL' or 'micromol/L' (=='umol/L')

race

'black' or 'other', Required for CKD-EPI and MDRD methods for estimating GFR. To use these methods without race, use 'method = "ckd_epi_ignore_race"', 'method = "ckd_epi_as_2021"', 'method = "mdrd_ignore_race"' or 'method = "mdrd_original_ignore_race"'. See Note section below for important considerations when using race as a predictive factor in eGFR.

weight

weight, in 'kg'

height

height, in 'cm', used for converting to/from BSA-normalized units.

bsa

body surface area

preterm

is patient preterm? Used for Schwartz method.

ckd

chronic kidney disease? Used for Schwartz method.

times

vector of sampling times (in days!) for creatinine (only used in Jelliffe equation for unstable patients)

bsa_method

BSA estimation method, see 'calc_bsa()' for details

relative

'TRUE'/'FALSE'. Report eGFR as per 1.73 m2? Requires BSA if re-calculation required. If 'NULL' (=default), will choose value typical for 'method'.

unit_out

'ml/min' (default), 'L/hr', or 'mL/hr'

verbose

verbosity, show guidance and warnings. 'TRUE' by default

min_value

minimum value ('NULL' by default). The cap is applied in the same unit as the 'unit_out'.

max_value

maximum value ('NULL' by default). The cap is applied in the same unit as the 'unit_out'.

fail

invoke 'stop()' if not all covariates available?

...

arguments passed on to 'calc_abw' or 'calc_dosing_weight'

use_race

whether to include race as a factor in the calculation (TRUE or FALSE); see note

original_expression

whether the MDRD equation should use the 2001 coefficient (TRUE) or the 2006 coefficient (FALSE), which was updated for standardization of the creatinine assay.

Note

The MDRD and CKD-EPI equations use race as a factor in estimation of GFR. Racism has historically been and continues to be a problem in medicine, with racialized patients experiencing poorer outcomes. Given this context, the use of race in clinical algorithms should be considered carefully (Vyas et al., NEJM (2020)). Provided here are versions of the CKD-EPI and MDRD equations that do not consider the race of the patient. Removing race from GFR estimation may lead to worse outcomes for Black patients in some contexts (Casal et al., The Lancet (2021)). On the other hand, including race in GFR estimation may also prevent Black patients from obtaining procedures like kidney transplants (Zelnick, et al. JAMA Netw Open. (2021)). In 2021, the NKF/ASN Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Diseases published revised versions of the CKD-EPI equations refit on the original data but with race excluded, which may produce less biased estimates (Inker, et al., NEJM (2021)).

References

Examples

calc_egfr(sex = "male", age = 50, scr = 1.1, weight = 70)
calc_egfr(sex = "male", age = 50, scr = 1.1, weight = 70, unit_out = "L/hr")
calc_egfr(sex = "male", age = 50, scr = 1.1, weight = 70, bsa = 1.8, method = "ckd_epi")
calc_egfr(sex = "male", age = 50, scr = c(1.1, 0.8),
  weight = 70, height = 170, method = "jelliffe")
calc_egfr(sex = "male", age = 50, scr = c(1.1, 0.8),
  weight = 70, height = 170, method = "jelliffe_unstable")
calc_egfr(sex = "male", age = 50, scr = 1.1,
  weight = 70, bsa = 1.6, method = "malmo_lund_revised", relative = FALSE)

[Package clinPK version 0.11.1 Index]