Clinical value of automatic reporting of estimated glomerular filtration rate in geriatrics.
BACKGROUND
Geriatric patients frequently have impaired renal function. Multimorbidity leads to polypharmacy with high risk of adverse drug reactions.


OBJECTIVE
The aim was to evaluate the prevalence of renal impairment and risk of overdosing renally excreted drugs in hospitalized geriatric patients.


METHODS
In 221 patients aged >or=65 years, GFR was estimated by the MDRD, Cockcroft-Gault (CG) and lean body mass (LBM)-adjusted CG equations.


RESULTS
A reduced renal function (<60 ml/min/1.73 m(2)) was found in 43% by MDRD, 61% by CG, and 71.9% by LBM-CG. The prevalence of severe impairment (<30 ml/min/1.73 m(2)) was 3.3% based on MDRD, 5.4% on CG, and 13.6% on LBM-CG. At mean 10 medications were applied simultaneously. In patients with reduced eGFR, 52% of medications required dosage adjustment. Unfractionated heparins, ACE inhibitors, antibiotics, diuretics, and potassium were frequently used.


CONCLUSIONS
For all limitations of formulaic GFR estimation in the elderly, routine assessment of renal function by reporting of eGFR helps to identify patients with chronic kidney disease and supports drug dosing. Implementation of routine reporting of eGFR is mandatory in standardized geriatric assessment.
Kurtal
Hanife
H
Charité - Universitatsmedizin Berlin, Campus Virchow-Klinikum, Research Group on Geriatrics, Ev Geriatriezentrum Berlin, Berlin, Germany.
Schwenger
Vedat
V
Azzaro
Marina
M
Abdollahnia
Nadja
N
Steinhagen-Thiessen
Elisabeth
E
Nieczaj
Rolf
R
Schulz
Ralf-Joachim
RJ
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D019411:Clinical Laboratory Techniques / Q000592:standards*; D015897:Comorbidity; D003404:Creatinine / Q000097:blood*; D005260:Female; D015577:Geriatric Assessment; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D012189:Retrospective Studies; D012737:Sex Factors; D018709:Statistics, Nonparametric
D003404:Creatinine