Discrepancy Between Equations Estimating Kidney Function in Geriatric Care: A Study of Implications for Drug Prescription
dc.rights.license | open | en_US |
dc.contributor.author | GUERVILLE, F. | |
dc.contributor.author | ROUBAUD-BAUDRON, C. | |
dc.contributor.author | DUC, S. | |
dc.contributor.author | SALLES, N. | |
hal.structure.identifier | Bordeaux population health [BPH] | |
dc.contributor.author | RAINFRAY, Muriel | |
dc.contributor.author | BOURDEL-MARCHASSON, I. | |
dc.date.accessioned | 2020-06-22T15:55:50Z | |
dc.date.available | 2020-06-22T15:55:50Z | |
dc.date.issued | 2019-02 | |
dc.identifier.issn | 1179-1969 (Electronic) 1170-229X (Linking) | en_US |
dc.identifier.uri | https://oskar-bordeaux.fr/handle/20.500.12278/8075 | |
dc.description.abstractEn | BACKGROUND: In older patients, the agreement is low between creatinine clearance estimated with the Cockcroft-Gault equation (eCrCl) and glomerular filtration rate estimated with the Chronic Kidney Disease Epidemiology Collaboration equation (eGFRCKD-EPI). The implications of these discrepancies for drug prescription have so far been assessed only for a few selected molecules. OBJECTIVE: The aim of this study was to investigate the proportion of geriatric patients receiving drugs with a different recommended dose or indication (i.e. an adjustment discrepancy) depending on eCrCl versus eGFRCKD-EPI estimates of kidney function. METHODS: Patients admitted to acute geriatric care units in our university hospital were eligible for inclusion. All drug classes were studied. We retrospectively determined recommended prescriptions according to eCrCl and eGFRCKD-EPI. RESULTS: Sixty percent of patients received at least one drug requiring dose adjustment and/or received a drug with a relative contraindication based on their estimated kidney function. Thirty-one percent of patients received at least one drug with an adjustment discrepancy: 20% received at least one drug for which the recommended dose differed depending on eCrCl versus eGFRCKD-EPI estimates of kidney function, 4% received a drug with a relative contraindication according to eCrCl but not eGFRCKD-EPI, and 7% received both. Factors independently associated with an adjustment discrepancy were older age and lower weight. Main drug classes involved were benzodiazepines, anticoagulants, and anti-microbial drugs. CONCLUSION: In acute geriatric care units, recommended drug dose adjustments are frequently discordant according to the equations used to estimate kidney function, notably for benzodiazepines, anticoagulants, and anti-microbial drugs. The consequences for treatment efficacy and safety should be investigated. | |
dc.language.iso | EN | en_US |
dc.subject.en | EPICENE | |
dc.title.en | Discrepancy Between Equations Estimating Kidney Function in Geriatric Care: A Study of Implications for Drug Prescription | |
dc.title.alternative | Drugs Aging | en_US |
dc.type | Article de revue | en_US |
dc.identifier.doi | 10.1007/s40266-018-0618-3 | en_US |
dc.subject.hal | Sciences du Vivant [q-bio]/Santé publique et épidémiologie | en_US |
bordeaux.journal | Drugs and Aging | en_US |
bordeaux.page | 155-163 | en_US |
bordeaux.volume | 36 | en_US |
bordeaux.hal.laboratories | Bordeaux Population Health Research Center (BPH) - UMR 1219 | en_US |
bordeaux.issue | 2 | en_US |
bordeaux.institution | Université de Bordeaux | en_US |
bordeaux.team | EPICENE_BPH | |
bordeaux.peerReviewed | oui | en_US |
bordeaux.inpress | non | en_US |
hal.export | false | |
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