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The assessment of renal function in relation to the use of drugs in elderly in nursing homes; a cohort study
Lund University, Malmö.
Futurum, Jönköping.
Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Primary Health Care in Motala.
Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences.
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2011 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 11, no 1Article in journal (Refereed) Published
Abstract [en]

Background

Renal function decreases with age. Dosage adjustment according to renal function is   indicated for many drugs, in order to avoid adverse reactions of medications and/or   aggravation of renal impairment. There are several ways to assess renal function in   the elderly, but no way is ideal. The aim of the study was to explore renal function   in elderly subjects in nursing homes and the use of pharmaceuticals that may be harmful   to patients with renal impairment.

Methods

243 elderly subjects living in nursing homes were included. S-creatinine and s-cystatin   c were analysed. Renal function was estimated using Cockcroft-Gault formula, Modification   of Diet in Renal Disease (MDRD) and cystatin C-estimated glomerular filtration rate   (GFR). Concomitant medication was registered and four groups of renal risk drugs were   identified: metformin, nonsteroidal anti-inflammatory drugs (NSAID), angiotensin-converting   enzyme -inhibitors/angiotensin receptor blockers and digoxin. Descriptive statistics   and the Kappa test for concordance were used.

Results

Reduced renal function (cystatin C-estimated GFR < 60 ml/min) was seen in 53%. Normal   s-creatinine was seen in 41% of those with renal impairment. Renal risk drugs were   rather rarely prescribed, with exception for ACE-inhibitors. Poor concordance was   seen between the GFR estimates as concluded by other studies.

Conclusions

The physician has to be observant on renal function when prescribing medications to   the elderly patient and not only rely on s-creatinine level. GFR has to be estimated   before prescribing renal risk drugs, but using different estimates may give divergence   in the results.

Place, publisher, year, edition, pages
BioMed Central, 2011. Vol. 11, no 1
Keyword [en]
drugs elderly nursing homes
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-75552DOI: 10.1186/1471-2318-11-1OAI: oai:DiVA.org:liu-75552DiVA: diva2:508144
Available from: 2012-03-07 Created: 2012-03-07 Last updated: 2017-12-07

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Östgren, Carl JohanMölstad, Sigvard

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CiteExportLink to record
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