Renal impairment and medication use among psychogeriatric inpatients.
OBJECTIVE
To determine the prevalence of renal impairment and the dosage appropriateness of several medications for which dosing guidelines in the advent of renal impairment are available.


METHODS
The authors assessed the renal function and medication use of 37 psychogeriatric patients (mean age of 75 years) living in a psychiatric hospital. Renal function was determined by serum creatinine (SCr) levels and creatinine clearance (CCr) data using the Cockcroft and Gault equation.


RESULTS
Thirteen of 37 patients (35%) were found to have renal impairment according to CCr data but only two patients (6%) were considered impaired according to SCr levels (k=0.19). Of 44 medications for which dosing guidelines were available, only two (5%) were prescribed inappropriately.


CONCLUSIONS
These data suggest that CCr data should be used over SCr levels to determine renal impairment and to support the monitoring of psychogeriatric patients for declines in renal function and required medication adjustments.
Bédard
Michel
M
Lakehead Psychiatric Hospital, Thunder Bay, Ontario, Canada. michel.bedard@lakeheadu.ca
Klein
Rupert
R
Papaioannou
Alexandra
A
Motyka
Sophia
S
Hutchinson
Lois
L
Clarke
Jo-Anne
JA
D000368:Aged; D000369:Aged, 80 and over; D003404:Creatinine / Q000378:metabolism*; D011307:Drug Prescriptions; D005260:Female; D006299:Health Services for the Aged; D006707:Homes for the Aged; D006760:Hospitalization; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000209:etiology*; D008134:Long-Term Care; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D009735:Nursing Homes; D009864:Ontario / Q000453:epidemiology; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D015995:Prevalence
D003404:Creatinine