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Creatinine Clearance:

Revised Schwartz Estimate


Estimate glomerular filtration rate (creatinine clearance) from serum creatinine and the
patient's height using the "interim IDMS-traceable" Schwartz estimate published in 2009.
Input Serum Creatinine

mg/dL

Input Height

cm in
Clear

GFR =
mL/min per 1.73 m
2

The revised Schwartz formula
1
is:
GFR =
0.413 * Ht
Cr
serum

Height is measured in cm. Serum creatinine is measured in mg/dL. Measured creatinine
should be in steady state. This formula may be most accurate in the range of 15 to 75 mL/min
per 1.73 m
2
. Values >75 should be reported as such rather than as a specific number.
This formula applies to enzymatic serum creatinine measurements calibrated to reference
measurements by isotope dilution mass spectroscopy (IDMS), but not to alkaline picrate
("Jaffe") methods, even those traceable to IDMS. (For more information see National Kidney
Disease Education Program.)
Serum samples that are hemolyzed or have elevated bilirubin may lower creatinine
measurements.
Many medications must be adjusted for renal impairment when the CrCl falls below 50
mL/min.
1. Schwartz GJ, Muoz A, Schneider MF, Mak RH, Kaskel F, Warady BA, Furth SL. J
Am Soc Nephrol. 2009 Mar;20(3):629-37
Special thanks to Dr. Megan Rashid, University of Rochester.
Created: September 28, 2010
Revised: October 14, 2010

Creatinine Clearance:
Original Schwartz Estimate
Estimate glomerular filtration rate (creatinine clearance) from serum creatinine, the patient's
height, and a proportionality constant using the original Schwartz method.

k
Infant (LBW < 1 year)
0.33
Infant (Term < 1 year)
0.45
Child or Adolescent Girl
0.55
Adolescent Boy
0.70


Input Serum Creatinine

mg/dL

Input Height

cm in
Clear

CrCl =
mL/min per 1.73 m
2


The original Schwartz formula
1,2
is:
CrCl =
(k * Ht)
Cr
serum

Height is measured in cm. Serum creatinine is measured in mg/dL. Measured creatinine
should be in steady state. This formula tends to overestimate the actual creatinine clearance
and should be used with caution. Estimates of glomerular filtration > 75 mL/min per 1.73 m
2

should not be reported as an exact number (National Kidney Disease Education Program
recommendation).
This formula should not be used with serum creatinine measurements calibrated to reference
measurements by isotope dilution mass spectroscopy (IDMS). See the Revised Schwartz
Estimate.
Many medications should be adjusted for renal impairment when the CrCl falls below 50
mL/min.
1. Schwartz GJ, Gauthier B. J Pediatr 1985 Mar;106(3):522-6
2. Schwartz GJ, Feld LG, Langford DJ. J Pediatr 1984 Jun;104(6):849-54
Created: January 7, 2000
Revised: October 14, 2010

GIR
This calculation is a simple conversion of units (into mg/kg/min):
GIR =
IV Rate (mL/hr) * Dextrose Conc (g/dL) * 1000 (mg/g)
Weight (kg) * 60 (min/hr) * 100 (mL/dL)
where the dextrose concentration is expressed as a whole number, e.g. 5 or 10.
A GIR of 5-8 mg/kg/min is typical. Infants who are not feeding should not be allowed a rate
less than 5 mg/kg/min for any significant period of time. The GIR needed to optimize
nutrition in neonates is 14 mg/kg/min.
Created: July 13, 2010
Revised: July 13, 2010
Oxygen Content
The equation is:
C
a
O
2
= 1.36 * Hgb *
S
a
O
2

+ 0.0031 * P
a
O
2

100
The constant, 1.36, is the amount of oxygen (ml at 1 atmosphere) bound per gram of
hemoglobin. The exact value of this constant varies from 1.34 to 1.39, depending on the
reference and the way it is derived. The constant 0.0031 represents the amount of oxygen
dissolved in plasma. The dissolved oxygen term is generally small relative to the
hemoglobin-bound oxygen, but becomes significant at very high P
a
O
2
(as in a hyperbaric
chamber) or in severe anemia.
Created: January 7, 2000
Revised: October 19, 2000

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