This document discusses methods for estimating glomerular filtration rate (GFR) using serum creatinine levels. It notes that creatinine clearance is commonly used to measure GFR and is dependent on age, weight, and gender. The Siersback-Nielsen nomogram estimates creatinine clearance based on age, weight, and serum creatinine concentration to determine appropriate dosing of medications like antibiotics in patients. It provides an example case of a 65-year old, 70kg female patient with a serum creatinine of 2.0 mg/dL.

1. SERUM CREATININE
Siersback-Nielsen Nomogram

2. CREATININE
• Creatinine clearance is used most extensively as a
measurement of GFR.
• Creatinine is an endogenous substance formed from
creatine phosphate during muscle metabolism
• Creatinine production depends on the age, weight, and
gender of the individual.
• In humans, creatinine is filtered mainly at the glomerulus,
with no tubular reabsorption.
• A small amount of creatinine may be actively secreted by
the renal tubules, resulting in GFR value greater than
Inulin.
• Creatinine clearance tends to decrease in the elderly
patient.

3. SERUM
CREATININE
• These Cl Cr methods are based on
solely on serum creatinine.

4. Siersback-Nielsen
Nomogram

5. Siersback-Nielsen
Nomogram
• The nomogram method
estimates creatinine
clearance on the basis
of age, weight, and
serum creatinine
concentration

6. A female patient (age=65 years &
weight=70 kg) is to be administered
lincomycin antibiotics. The serum
creatinine concentration of the patient
is 2.0 mg/dL. What dose will be
administered to the patient.?

7. Pt Weight = 70 kg
pt age = 65 years
serum creatinine conc = 2.0 mg/dL
lin