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Discrepancy Between Equations Estimating Kidney Function in Geriatric Care: A Study of Implications for Drug Prescription

dc.rights.licenseopenen_US
dc.contributor.authorGUERVILLE, F.
dc.contributor.authorROUBAUD-BAUDRON, C.
dc.contributor.authorDUC, S.
dc.contributor.authorSALLES, N.
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorRAINFRAY, Muriel
dc.contributor.authorBOURDEL-MARCHASSON, I.
dc.date.accessioned2020-06-22T15:55:50Z
dc.date.available2020-06-22T15:55:50Z
dc.date.issued2019-02
dc.identifier.issn1179-1969 (Electronic) 1170-229X (Linking)en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/8075
dc.description.abstractEnBACKGROUND: 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.isoENen_US
dc.subject.enEPICENE
dc.title.enDiscrepancy Between Equations Estimating Kidney Function in Geriatric Care: A Study of Implications for Drug Prescription
dc.title.alternativeDrugs Agingen_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1007/s40266-018-0618-3en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
bordeaux.journalDrugs and Agingen_US
bordeaux.page155-163en_US
bordeaux.volume36en_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - U1219en_US
bordeaux.issue2en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.teamEPICENE_BPH
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.exportfalse
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