Compare carboplatin dosed by BSA-adjusted CKD-EPI eGFR with Cockcroft-Gault on toxicity and response

The recommendation. ADDIKD (2025) recommends BSA-adjusted eGFR CKD-EPI as an alternative to measured GFR in the Calvert formula, on clinical consensus with a strong recommendation, and calls the switch away from creatinine clearance a significant practice change, given the long reliance on creatinine clearance calculated by the Cockcroft-Gault equation. It notes that many prescribing software packages use creatinine clearance by default.

The evidence. In 2,471 patients at Cambridge, BSA-adjusted CKD-EPI was the most accurate published estimate against measured GFR, and Cockcroft-Gault gave a dose more than 20% off in 25.5% of patients against 18.6% (Janowitz 2017, abstract). These are dose-accuracy outcomes; ADDIKD's own outstanding questions add that cystatin C-based equations may be more accurate where eGFR is unreliable.