title: Optimal screening cut-off points for renal impairment in rural Korean older adults taking medications.
abstract: The purpose of this descriptive, cross-sectional study was to identify the optimal cut-off point of estimated glomerular filtration rate (eGFR) using the area under the receiver operating characteristic curve to screen for renal impairment among rural Korean older adults taking medications (N = 100). Renal function was assessed by eGFR using the Cockcroft-Gault formula. Nearly half of participants took five or more prescription drugs, and 46% took nephrotoxic medications. Participants' optimal eGFR cut-off points in screening for renal impairment with and without polypharmacy were 54.3 mL/min (area under curve [AUC] = 0.824, p < 0.001) and 61.4 mL/min (AUC = 0.768, p < 0.001), respectively. The incidence of renal impairment was 61.2% and 56.9%, respectively, using 54.3 mL/min and 61.4 mL/min as the new optimal cut-offs of eGFR with and without polypharmacy. More than half of the rural older adults require a reduction in medication dosage or a change to non-nephrotoxic medications. These new optimal cut-off points using eGFR according to polypharmacy may be helpful in screening for renal impairment among rural older adults taking medications.
authors.affiliation: Ajou University College of Nursing, Suwon, South Korea.
authors.forename: Chun-Ja
authors.initials: CJ
authors.lastname: Kim
authors.forename: Dong-Soo
authors.initials: DS
authors.lastname: Shin
mesh_terms: D000368:Aged; D064420:Drug-Related Side Effects and Adverse Reactions; D004509:Education, Nursing, Continuing; D005260:Female; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D056910:Republic of Korea; D012424:Rural Population