Creatinine Clearance Calculator — Cockcroft-Gault (Drug Dosing) — Rounds AI
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Citation-first clinical tool

Creatinine Clearance Calculator — Cockcroft-Gault (Drug Dosing)

The Cockcroft-Gault equation estimates creatinine clearance from age, weight, and serum creatinine. Although CKD-EPI 2021 is the preferred equation for chronic kidney disease staging, the FDA continues to reference Cockcroft-Gault on most drug labels for renal-dose adjustment. Cockcroft-Gault returns CrCl in mL/min (not normalised to body surface area), with a 0.85 multiplier for female sex from the original 1976 derivation. Clinically, the equation underperforms in obesity, oedema, and at extremes of muscle mass; the corresponding CKD-EPI eGFR or measured CrCl may be more reliable in those settings.

This tool is for educational and decision-support use only. It does not replace independent clinical judgement. Always verify against the current guideline, FDA label, or specialty reference cited below before acting. Do not enter patient identifiers (name, MRN, dates of service).

Tool

Cockcroft-Gault (1976). Many institutional pharmacies use ideal or adjusted body weight in obesity.
FDA Pharmacokinetics in Patients with Impaired Renal Function — Industry Guidance (2020) — U.S. Food and Drug Administration — read source Primary publication: Cockcroft DW, Gault MH. Nephron 1976

Who this is for

  • Pharmacists and clinicians dosing renally cleared medications
  • Internal medicine residents
  • Hospitalists and nephrology consult services

How to interpret the result

Score / bandInterpretation
≥ 60Most renally cleared drugs require no adjustment unless the label specifies otherwise.
30–59Moderate impairment — many drug labels specify dose reduction or interval extension.
15–29Severe impairment — commonly large dose reductions or alternative agents.
< 15 / dialysisSpecific dialysis-aware dosing protocols apply.

Frequently asked questions

Why does the FDA still use Cockcroft-Gault?
Cockcroft-Gault was used in the pivotal pharmacokinetic studies of most marketed drugs, so the FDA references it on labels for consistency. Newer equations (CKD-EPI) may give different bands and shift dose categories.
Should I use actual, ideal, or adjusted body weight?
The original derivation used actual body weight. For obese patients, many institutional pharmacies use ideal or adjusted body weight to avoid overestimating CrCl. Verify with your pharmacy.
Cockcroft-Gault vs eGFR — which gives a higher number?
Generally, Cockcroft-Gault (mL/min) and eGFR (mL/min/1.73 m²) are similar in average-sized adults but diverge at extremes of body size because eGFR is BSA-normalised.
Is Cockcroft-Gault reliable in AKI?
No. Both Cockcroft-Gault and eGFR assume steady-state creatinine. In AKI, neither is reliable; clinical judgement and direct measurement (timed urine collection) may be needed.
Should pharmacists round Cockcroft-Gault to a category?
Many institutional protocols round to FDA-label categories (e.g. CrCl ≥ 60, 30–59, 15–29, < 15) rather than treating the number as exact. Verify your institutional convention.
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