Cocchetto D M, Tschanz C, Bjornsson T D
Ther Drug Monit. 1983 Jun;5(2):161-8. doi: 10.1097/00007691-198306000-00002.
Serum creatinine concentration is commonly used in conjunction with individual patient characteristics (e.g., age, sex, and body weight) in order to estimate creatinine clearance. Such estimates of creatinine clearance are widely used as a parameter for individualization of dosages of drugs excreted primarily via the kidneys in patients with diminished renal function. However, estimation of creatinine clearance in patients with concurrent hepatic disease tends to result in substantial overprediction of observed creatinine clearance in this patient population. This report suggests that a diminished rate of creatinine production in patients with hepatic disease is a likely explanation for this anomaly. This postulated mechanism is based on a presentation of the biology of creatinine formation.
血清肌酐浓度通常与患者个体特征（如年龄、性别和体重）结合使用，以估算肌酐清除率。这种肌酐清除率的估算值被广泛用作肾功能减退患者中主要经肾脏排泄的药物剂量个体化的参数。然而，在合并肝病的患者中估算肌酐清除率往往会导致对该患者群体中观察到的肌酐清除率出现大幅高估。本报告表明，肝病患者肌酐生成速率降低可能是这种异常情况的一个解释。这一假设机制基于对肌酐形成生物学的阐述。
