In the setting of rapidly improving/worsening renal function, calculations of eGFR are inaccurate, and dosing should be based on estimated renal function instead.
If worsening renal function, actual GFR is likely lower than calculated.
If improving renal function, actual GFR is likely higher than calculated eGFR.
Not On Dialysis (EGFR)
2.25g IV q6h
3.375g IV q6h
3.375-4.5g IV q6h
Intermittent Dialysis
2.25g IV q8h
Continuous Dialysis
3.375g IV q6h