From the Research
Creatinine clearance is approximately 55 mL/min based on the provided GFR value of 55, which is a more reliable measure of kidney function than serum creatinine alone 1. The serum creatinine of 1.28 mg/dL indicates mild to moderate kidney dysfunction. In clinical practice, GFR (Glomerular Filtration Rate) is the preferred measure of kidney function and is essentially equivalent to creatinine clearance when adjusted for body surface area. The slight elevation in serum creatinine (normal range typically 0.7-1.2 mg/dL) corresponds with the reduced GFR, as these values have an inverse relationship. This level of kidney function represents Stage 3a chronic kidney disease according to standard classifications. When interpreting these values for medication dosing, many drugs require dose adjustment at this level of kidney function, and the CKD-EPI equation adjusted for body surface area has been shown to be a reliable predictor of aminoglycoside clearance 2. Regular monitoring of kidney function would be recommended, along with addressing any underlying causes of kidney dysfunction such as hypertension, diabetes, or medication effects. Lifestyle modifications including adequate hydration, blood pressure control, and avoiding nephrotoxic medications would be appropriate interventions. It's also important to note that while serum creatinine can be misleading, especially in ICU patients, the use of cystatin C-based equations can provide a more accurate estimate of GFR 3. However, in this case, the provided GFR value of 55 is a more direct and reliable measure of kidney function.