Creatinine Clearance Calculator (Cockcroft–Gault)
Enter age, weight, serum creatinine (Scr) and sex; the tool applies the 1976 Cockcroft & Gault formula to estimate creatinine clearance (CrCl): ((140 − age) × weight) / (72 × Scr_mg/dL) × (× 0.85 for females). Although CKD staging now uses CKD-EPI eGFR (2021), the FDA and EMA still require Cockcroft–Gault CrCl for renal dose adjustment in nearly every drug label.
Enter a valid age (18–120), weight (20–300 kg) and serum creatinine (> 0).
Result
Creatinine clearance (CrCl)
88 mL/min
Mildly decreased
CrCl 60–89 mL/min — mild reduction; most drugs still at standard dose, but check renally-cleared agents.
Serum creatinine (both units)
1.00 mg/dL · 88.40 μmol/L
Cockcroft–Gault 1976 — still required by the FDA / EMA for renal dose adjustment; use CKD-EPI eGFR for CKD staging. For clinical reference only.
Formula
CrCl (mL/min) = ((140 − age) × weight_kg) / (72 × Scr_mg/dL) Female: × 0.85 (SI unit conversion: Scr_mg/dL = Scr_μmol/L ÷ 88.4)
- · Scr units: mg/dL is the US / Japan convention; μmol/L is used across the UK, EU and Hong Kong. Conversion: 1 mg/dL = 88.4 μmol/L.
- · The result is in mL/min (not normalised to BSA), whereas CKD-EPI eGFR is mL/min/1.73 m² — the two numbers are not directly comparable.
- · In severely obese patients (BMI ≥ 30), actual body weight over-estimates CrCl; clinicians typically use ideal body weight (IBW) or adjusted body weight (IBW + 0.4 × (actual − IBW)).
- · For amputees, patients with very low muscle mass (frail elderly, bedbound, ICU) or very high muscle mass (bodybuilders), Scr is decoupled from muscle mass and both Cockcroft–Gault and eGFR systematically err — a measured 24 h urinary CrCl is preferred.
- · Bands follow FDA / KDIGO: ≥ 90 normal, 60–89 mild, 30–59 moderate, 15–29 severe, < 15 kidney failure.
- · References: Cockcroft DW, Gault MH. Nephron 1976;16(1):31–41; FDA "Pharmacokinetics in Patients with Impaired Renal Function" 2020; KDIGO 2024 CKD Guideline.
Frequently asked
We already have CKD-EPI eGFR (2021); why still bother with Cockcroft–Gault?
Two reasons. First: the renal dose-adjustment guidance for the vast majority of existing drugs (FDA and EMA labels) was set in the 1980s–2010s using Cockcroft–Gault CrCl, and the underlying clinical trials stratified patients by CrCl. Even with the newer eGFR available, drug labels still specify CrCl bands (this is explicitly preserved by the FDA's 2020 guidance). Picking the dose bracket using eGFR instead can land you in the wrong bracket. Second: the units differ — CrCl is mL/min (absolute), eGFR is mL/min/1.73 m² (BSA-normalised). For patients with extreme body sizes (children aside, adult BSA still varies meaningfully) the two numbers can differ by 10–25 %. So: use eGFR for CKD staging and disease monitoring, but use CrCl for drug dosing — do not mix them.
Should I use actual, ideal or adjusted body weight?
Classic rules: (1) underweight patients (lean, elderly, malnourished) — use actual body weight (ABW). (2) Patients within ±20 % of ideal body weight (IBW) — use ABW. (3) BMI ≥ 30 obese patients — ABW noticeably over-estimates CrCl, because adipose tissue produces much less creatinine than muscle. Most clinical guidance (ASHP, IDSA) recommends IBW (Devine: male 50 + 2.3 × (inches − 60); female 45.5 + 2.3 × (inches − 60)) or adjusted body weight ABW_adj = IBW + 0.4 × (ABW − IBW). Which one is correct usually depends on the drug label or institutional protocol. Practical advice: pharmacy / clinical-decision tools usually start with ABW as the baseline, surface the BMI in the report, and let the clinician decide whether to switch to IBW or ABW_adj based on the drug. This calculator uses ABW by default and surfaces the obesity caveat in the weight-input hint.
Elderly patients have "normal" Scr but a noticeably low CrCl — is that real?
Yes. Scr does not reflect kidney excretion directly — it reflects the *balance* between creatinine production (muscle mass) and renal excretion. With age: (1) muscle mass falls by roughly 0.5–1 % per year (sarcopenia); (2) glomerular filtration also declines by about 0.8 mL/min per year. Because the two effects offset each other, Scr can stay within the lab's reference range (e.g. 0.9 mg/dL) even as CrCl drops from 90 mL/min to under 50 mL/min. This is precisely what the (140 − age) term in Cockcroft–Gault captures — it builds the age effect directly into the formula. Clinical takeaway: a "normal" Scr in an 80-year-old absolutely does not mean normal kidney function. Renal dose adjustment must use CrCl, not Scr alone — particularly for renally-cleared narrow-therapeutic-index drugs (vancomycin, digoxin, sulfa drugs) where missed dose adjustment can produce toxicity.
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