Creatinine Clearance (Cockcroft-Gault)

Estimate glomerular filtration rate (GFR) to guide renal medication dosing.

Estimated CrCl
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mL/min

What is the Cockcroft-Gault Equation?

The Cockcroft-Gault equation is a widely used clinical formula that estimates creatinine clearance (CrCl). Creatinine clearance provides an approximation of the glomerular filtration rate (GFR), which is a key measure of kidney function.

Standard Reference Ranges (mL/min)

  • Normal Function > 90
  • Mild Impairment 60 – 89
  • Moderate Impairment 30 – 59
  • Severe Impairment 15 – 29
  • Kidney Failure < 15

Clinical Significance

Estimating renal function is crucial for appropriately dosing medications that are cleared by the kidneys. While newer equations like MDRD and CKD-EPI are often used to stage chronic kidney disease, the Cockcroft-Gault formula remains the standard for pharmacokinetic dosing adjustments for many drugs.

Case Scenario

Case: A 75-year-old female (Weight: 60 kg, SCr: 1.5 mg/dL) requires a renally cleared antibiotic.

Calculation: [(140 - 75) × 60] / (72 × 1.5) = 36.1 mL/min. Multiplied by 0.85 (female) = 30.7 mL/min.

Interpretation: 30.7 mL/min (Moderate renal impairment).

Next Steps: The clinician checks the drug monograph and reduces the dose or extends the dosing interval according to the guidelines for CrCl 30-50 mL/min.

Frequently Asked Questions

Should I use Actual, Ideal, or Adjusted Body Weight?

The original Cockcroft-Gault study used actual body weight. However, for obese patients (typically >30% over Ideal Body Weight), using actual body weight may overestimate CrCl. Many institutions prefer using Adjusted Body Weight in obese patients, but practices vary.

Can I use this for Acute Kidney Injury (AKI)?

No. The equation assumes stable renal function and a steady state of serum creatinine. In AKI, creatinine levels fluctuate rapidly, making this formula inaccurate.

Why is there a 0.85 multiplier for females?

Females generally have a lower proportion of muscle mass to total body weight compared to males. Since creatinine is a byproduct of muscle metabolism, this correction factor accounts for the lower endogenous creatinine production.

How to Use

Input the patient's age, weight, serum creatinine, and sex. The Cockcroft-Gault formula will calculate the estimated creatinine clearance.

Clinical Guidance & Next Steps