Caught Between Equations: The Shift from Cockroft Gault to CKD-EPI 2021 and Its Implications for Medication Dosing in Older Adults
Multiple comorbidities, polypharmacy, and exposure to renal toxins increase the risk of CKD and complicate the assessment of renal function in older adults. Renal dosage optimization for medications FDA-approved prior to 2009 was based on estimated creatinine clearance (eCrCl) using the Cockcroft Gault (C-G) equation and some variation of weight (actual, ideal, or adjusted) and serum creatinine (Scr). Between 2009-2024, manufacturers used eCrCl or estimated glomerular filtration rate (eGFR) during drug development to recommend renal dosing adjustments. In 2024 a National Kidney Foundation (NKF) workgroup released a consensus statement recommending replacement of eCrCl with a race-free eGFR based on the 2021 CKD-EPIcr-cys equation using Scr and cystatin C (cys) biomarkers standardized for body surface area (BSA). Data in adults 65 years of age and older are limited due to the discordance between the equations available to estimate measured kidney function (e.g., measured CrCl (mCrCl) or measured GFR (mGFR). This continues to be an area for pharmacist interventions.
This activity is a recording from a live webinar (on 11/18/2025) and those that claim credit for the live webinar should not claim credit for this activity.
CE Credit: 0.5 Contact Hours
Universal Activity Number (UAN): 0025-0000-25-117-H01-P
Activity Type: Knowledge
Launch Date: 11/18/2025
Expiration Date: 11/18/2025
Course Number: CTIP_2025_11_18_Van
Target Audience: Pharmacists
Course Details (Activity Announcement): View File (HTIP_2025_11_04_Van Activity Announcement)
Presenter:
Cindy Van, PharmD
Peter Lamy Center on Drug Therapy and Aging Geriatric Pharmacotherapy Fellow
University of Maryland
The University of Maryland School of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.
Learning Objectives
At the end of this activity, the participant should be able to:
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Explain the differences in eCrCl (C-G; Scr; body weight), eGFR by 2021 CKD-EPIcr, and 2021 CKD-EPICrcyst equations standardized for BSA in adults +65 years of age.
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Summarize the impact on dosage calculations for medications (e.g., cisplatin, gabapentin, and apixaban commonly prescribed in older persons and cleared by renal elimination.
Instructor
Cindy Van, PharmD
Peter Lamy Center on Drug Therapy and Aging Geriatric Pharmacotherapy Fellow
University of Maryland
Dr. Van, speaker for this activity, has no financial relationships to disclose. None of the planners for this activity have any financial relationships to disclose.
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Windows
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MacOS
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|
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6 GB (or more) |
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PC: 2 GHz or faster Intel processor
MacOS: Multi-core Intel processor |
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High speed internet connection |
| Other |
Participants must be able to play audio (either through speakers or headphones) as well as ability to open PDF files and view and edit Word, and PPT documents. |
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