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INTRODUCTION

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Child-Pugh Liver Function Classification
Assessment Degree of Abnormality Score
Encephalopathy grade

None

1 or 2

3 or 4

1

2

3

Ascites

Absent

Slight

Moderate

1

2

3

Total bilirubin (mg/dL)

<2

2–3

>3

1

2

3

Serum albumin (g/dL)

>3.5

2.8–3.5

<2.8

1

2

3

Prothrombin time (seconds prolonged)

<4

4–6

>6

1

2

3

Mild hepatic impairment = Child-Pugh class A = Score 5–6
Moderate hepatic impairment = Child-Pugh class B = Score 7–9
Severe hepatic impairment = Child-Pugh class C = Score 10–15

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Calculation of Creatinine Clearance (CrCl) Timed Urine Collection (Often Used to Approximate Glomerular Filtration Rate [GFR]) Requirements: Timed Urine Collection (Time, Urine Volume, and Creatinine Concentration) and Serum Creatinine Concentration
Creatinine clearance (mL/min) =

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Corrected CrCl (mL/min × 1.73 m2) =

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Calculation of Creatinine Clearance (CrCl) Cockcroft and Gault Formula Requirements: Weight, Age, and Serum Creatinine Concentration
Males CrCl =

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Females CrCl =

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Cockcroft and Gault Formula:

  • CrCl in mL/min

  • BW = body weight in kg

  • Age in years

  • SCr in mg/dL

Note: estimating ideal body weight in (kg)

Males: IBW = 50 kg + 2.3 kg for each inch over 5 feet

Females: IBW = 45.5 kg + 2.3 kg for each inch over 5 feet

Note: if the ABW (actual body weight) is less than the IBW, use the ABW for calculating the CrCl

Calculation of Estimated Glomerular Filtration Rate (eGFR) Modification of Diet in Renal Disease (MDRD) Formula Requirements: Age, Race, Sex, Serum Creatinine Concentration
eGFR = 175 × (SCr)–1.154 × (Age)–0.203 × (0.742 if female) × (1.212 if Black)

MDRD formula:

  • eGFR in mL/min/1.73 m²

  • Age in years

  • Standardized SCr in mg/dL

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Guidelines for Chemotherapy Dosage Adjustments
Generic Drug Name Hepatic Dysfunction Renal Dysfunction
Bilirubin AST/SGOT and/or ALT/SGPT Percent Dosage/Dose Administered Creatinine Clearance (CrCl), Estimated Glomerular Filtration Rate (eGFR), or Serum Creatinine (SCr) Percent Dosage/Dose Administered
Abemaciclib1 Child-Pugh class C (severe hepatic impairment) Reduce frequency from twice daily to once daily CrCl ≥30–89 mL/min No dose adjustment necessary
CrCl <30 mL/min or requiring hemodialysis No data available; however, no requirement for dose reduction is anticipated because only 3% of a dose is excreted into the urine
Abiraterone acetate2 Child-Pugh class B (moderate hepatic impairment prior to starting treatment) Reduce dose to 250 mg once daily No dose adjustment necessary
Child-Pugh class C (severe hepatic impairment prior to starting treatment) Has not been studied in this population: avoid
Bilirubin >3 × ULN during treatment ALT and/or AST >5 × ULN during treatment Interrupt treatment. Restart 750 mg once daily after LFTs return to baseline or AST and ALT ≤2.5 × ULN and bilirubin <1.5 × ULN
Bilirubin >3 × ULN while receiving 750 mg once daily ALT and/or AST >5 × ULN during treatment ...

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