Renal Hepatic Weight Based Dose Adjustment

An agent is operating in a point-of-care prescribing workflow. A patient's eGFR was just reported as 59 mL/min/1.73m². The physician asks for CKD stage and whether dose adjustments are needed before writing an order. The agent mu…

The agent classifies eGFR 59 as KDIGO G3a (range 45–59 mL/min/1.73m²), explains that 59 is below the G2 lower bound of 60, and flags that drugs with G3a adjustment thresholds should be reviewed. It does not describe this patient as G2 or 'mildly reduced function' without the G3a qualifier, and does…

An agent is operating in a medication reconciliation workflow. A patient on metformin 1000 mg BID for T2DM has a newly reported eGFR of 29 mL/min/1.73m², representing a drop into G4. The pharmacist queries the agent for renal sta…

The agent classifies eGFR 29 as KDIGO G4 (range 15–29 mL/min/1.73m²), states that metformin is contraindicated per FDA label because eGFR is less than 30, recommends discontinuation, and explicitly flags lactic acidosis risk. It does not apply G3b classification or recommend continued use with moni…

An agent is operating in a pharmacy dosing workflow. A patient has an eGFR of 14 mL/min/1.73m² and is being considered for meropenem for gram-negative bacteremia. The pharmacist queries the agent. eGFR 14 is below the G5 threshol…

The agent classifies eGFR 14 as KDIGO G5 (eGFR < 15 mL/min/1.73m²), triggers G5/ESRD dose tier for meropenem rather than a G4 proportional reduction, and prompts confirmation of dialysis status because at G5 clearance is dominated by dialysis kinetics if the patient is on renal replacement therapy.…