Key result
The C&Gcc, C&Guc, and BIS2 equations gave the best estimate of kidney function compared to mGFR, whereas other eGFR methods showed significantly higher clearance, risking over-dosing in elderly women.
Why the study?
The study evaluated renal function estimation using several GFR formulas in relation to renal risk drugs in hospitalized elderly patients.
Does the choice of GFR estimation formula affect the accuracy of renal function assessment and dosing of renal risk drugs in hospitalized elderly patients?
Observational (n=96)
No
Does the choice of GFR estimation formula affect the accuracy of renal function assessment and dosing of renal risk drugs in hospitalized elderly patients?
In hospitalized elderly patients, particularly women over 75, C&G and BIS2 equations provide safer and more accurate estimates of kidney function for drug dosing compared to MDRD4, CKD-EPI, and CAPA.
AIM: To compare renal function by several GFR formulas (particularly cystatin C eGFR-"CAPA") in relation to renal risk drugs (RRDs) in patients admitted to two geriatric wards in a university geriatric department. MATERIALS AND METHODS: . Agreement was tested by Bland & Altman analysis. The number and type of RRDs were analyzed. RESULTS: , respectively. Compared to mGFR, women had significantly higher clearance for all estimates except for C&Gcc and C&Guc. C&Gcc, C&Guc, and BIS2 showed the lowest bias. 38 RRDs were identified. 96 patients used a mean of 2.3 RRDs per patient, and 1.7 RRDs needed dose adjustments. Cardiovascular drugs and analgesics were the most frequent RRDs. DISCUSSION: The C&Gcc, C&Guc, and BIS2 equations gave the best estimate of kidney function in relation to mGFR for drug dosing in the elderly. The eGFR methods showed significantly higher clearance than mGFR, C&Gcc, C&Guc, and BIS2. RRDs that needed dose adjustment were common in this geriatric population. If the eGFR formulas (MDRD4, CKD-EPI, and CAPA) are used instead of C&Gcc, C&Guc, and BIS2, higher and potentially more risky doses of RRDs may be administered to geriatric patients over 75 years, women in particular.
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Helldén et al. (2019) conducted an observational in hospitalized elderly patients (n=96). eGFR formulas (MDRD4, CKD-EPI, CAPA) vs. mGFR, C&Gcc, C&Guc, and BIS2 was evaluated on Agreement of GFR formulas with mGFR. The C&Gcc, C&Guc, and BIS2 equations gave the best estimate of kidney function compared to mGFR, whereas other eGFR methods showed significantly higher clearance, risking over-dosing in elderly women.
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