The patient is a 28-year-old Hispanic female with a past medical history of
hypertension, high serum cholesterol, and gastritis who presented to the emergency
room for the evaluation of abdominal pain of 2 days duration. Six months prior, she
had similar pain. An upper gastrointestinal (GI) endoscopy at that time showed
peptic ulcer disease and no other mucosal lesions. The patient had a strong family
history of renal disease and 2 of her siblings required a renal transplant, but she
did not know what kidney pathology they had. Her medications included Lisinopril
oral 10 mg tablet daily and Pantoprazole oral 40 mg daily. On presentation at the
emergency room (ER), her height and weight were 157 cm and 61 kg, respectively, and
her blood pressure was 206/121 mm Hg. On physical examination, the patient had
epigastric tenderness. The rest of her physical examination was unremarkable.
Radiology was ordered to exclude any anatomical abnormality. A computed tomography
scan showed neither atrophy nor enlargement of the kidneys. She then followed up as
an outpatient with a nephrologist shortly after her ER visit. Her laboratory work up
during that visit revealed the following: nephrotic range proteinuria (9.2 g protein
on 24-hour urine collection; reference range, 0-2.5 g/d), hypoalbuminemia (300
µmol/L; reference range, 421-662 µmol/L), hypoproteinemia (50 g/L; reference range,
60-80 g/L), elevated serum creatinine (148.5 µmol/L; reference range, 44-80 μmol/L),
high chloride (110 mmol/L; reference range, 98-106 mmol/L), and low hemoglobin (100
g/L; reference range, 120-160 g/L). The lipid profile showed an increased total
cholesterol level (8.3 mmol/L; reference range, <5.2 mmol/L), elevated
triglycerides (3.7 mmol/L; reference range, <1.70 mmol/L), elevated low-density
lipoprotein fraction (5.9 mmol/L; reference range, <2.6 mmol/L), and decreased
high-density lipoprotein fraction (1.1 mmol/L; reference range, ≥1.55 mmol/L). After
treating her blood pressure, the patient underwent a US-guided renal biopsy.
The formula for computing Cockcroft-Gault is given by CrCl = ((140 - age) * adjusted weight * (gender_coefficient)) / (serum creatinine * 72), where the gender_coefficient is 1 if male, and 0.85 if female. The serum creatinine concentration is in mg/dL.
The patient's gender is female, which means that the gender coefficient is 0.85.
The patient is 28 years old. 
The concentration of creatinine is 148.5 µmol/L. We need to convert the concentration to mg/dL. Let's first convert the mass of creatinine from µmol to mg. The mass of creatinine is 148.5 µmol. To convert 148.5 µmol of creatinine to mol, multiply by the conversion factor 1e-06, giving us 148.5 µmol creatinine * 1e-06 mol/µmol = 0.000149 mol creatinine. To convert from mol creatinine to grams, multiply by the molar mass 113.12 g/mol, which will give 0.000149 mol creatinine * 113.12 g/mol = 0.017 g creatinine. To convert 0.017 g of creatinine to mg, multiply by the conversion factor 1000.0, giving us 0.017 g creatinine * 1000.0 mg/g = 17.0 mg creatinine. The current volume unit is L and the target volume unit is dL. The conversion factor is 10.0 dL for every unit of L. Our next step will be to divide the mass by the volume conversion factor of 10.0 to get the final concentration in terms of mg/dL. This will result to 17.0 mg creatinine/10.0 dL = 1.7 mg creatinine/dL. The concentration value of 148.5 µmol creatinine/L converts to 1.7 mg creatinine/dL. 
The formula for computing the patient's BMI is (weight)/(height * height), where weight is the patient's weight in kg and height is the patient's height in m.
The patient's height is 157.0 cm, which is 157.0 cm * 1 m / 100 cm = 1.57 m. The patient's weight is 61.0 kg. The patient's bmi is therefore 61.0 kg / (1.57 m * 1.57 m) = 24.747 kg/m^2.The patient's BMI is 24.7, indicating they are normal weight.
Because the patient is normal, we take take minimum of the ideal body weight and the patient's body as the patient's adjusted weight for the Cockroft-Gault Equation. Hence, the adjusted body weight is the minimum of the two giving us an adjusted body weight of 49.665 kg.

Using the Cockcroft-Gault equation:
CrCl = ((140 - age) * adjusted weight * gender_coefficient) / (serum creatinine * 72).
Plugging the patient's values gives us ((140 - 28) * 49.665 * 0.85) / (1.7 * 72) = 38.628 mL/min. Hence, the patient's creatinine clearance is 38.628 mL/min.