The assessment of renal function in relation to the use of drugs in elderly in nursing homes; a cohort study

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...

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Published inBMC geriatrics Vol. 11; no. 1; p. 1
Main Authors Modig, Sara, Lannering, Christina, Östgren, Carl Johan, Mölstad, Sigvard, Midlöv, Patrik
Format Journal Article
LanguageEnglish
Published England BioMed Central Ltd 11.01.2011
BioMed Central
BMC
Subjects
Aged
Aged, 80 and over
Analysis
Angiotensin-Converting Enzyme Inhibitors - pharmacokinetics
Angiotensin-Converting Enzyme Inhibitors - pharmacology
Anti-Arrhythmia Agents - administration & dosage
Anti-Inflammatory Agents, Non-Steroidal - pharmacokinetics
Clinical Medicine
Cohort Studies
Comorbidity
Creatinine - blood
Cystatin C - blood
Dermatologi och venerologi, klinisk genetik, invärtesmedicin
Dermatology and venerology,clinical genetics, internal medicine
Diabetes
Digoxin - administration & dosage
Drug therapy
drugs elderly nursing homes
Female
Frailty
Geriatric Assessment
Geriatrics
Geriatrics and medical gerontology
Geriatrik
Geriatrik och medicinsk gerontologi
Glomerular Filtration Rate - drug effects
Glomerular Filtration Rate - physiology
Health aspects
Humans
Internal medicine
Invärtesmedicin
Kidney - drug effects
Kidney - metabolism
Kidney diseases
Kidney Function Tests
Kidneys
Klinisk medicin
Male
Medical and Health Sciences
MEDICIN
Medicin och hälsovetenskap
MEDICINE
Nursing home patients
Nursing Homes
Patient outcomes
Renal Insufficiency - diagnosis
Renal Insufficiency - epidemiology
Renal Insufficiency - metabolism
Studies
Sweden
Online AccessGet full text
ISSN1471-2318
1471-2318
DOI10.1186/1471-2318-11-1

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Abstract 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. 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. 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. 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.
AbstractList 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. 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. 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. 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.
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.BACKGROUNDRenal 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.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.METHODS243 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.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.RESULTSReduced 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.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.CONCLUSIONSThe 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.
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 [less than] 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.
Abstract 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.
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.
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. 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. Reduced renal function (cystatin C-estimated GFR [less than] 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. 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.
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 &lt; 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.
ArticleNumber 1
Audience Academic
Author Modig, Sara
Mölstad, Sigvard
Midlöv, Patrik
Lannering, Christina
Östgren, Carl Johan
AuthorAffiliation 3 Department of Medical and Health Sciences, Primary Care, Linköping University, Linköping, Sweden
2 Unit of Research and Development in Primary Care, Futurum, Jönköping, Sweden
1 Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University, Malmö, Sweden
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– name: 1 Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University, Malmö, Sweden
– name: 3 Department of Medical and Health Sciences, Primary Care, Linköping University, Linköping, Sweden
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  surname: Modig
  fullname: Modig, Sara
– sequence: 2
  givenname: Christina
  surname: Lannering
  fullname: Lannering, Christina
– sequence: 3
  givenname: Carl Johan
  surname: Östgren
  fullname: Östgren, Carl Johan
– sequence: 4
  givenname: Sigvard
  surname: Mölstad
  fullname: Mölstad, Sigvard
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  surname: Midlöv
  fullname: Midlöv, Patrik
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ContentType Journal Article
Copyright COPYRIGHT 2011 BioMed Central Ltd.
2011 Modig et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright ©2011 Modig et al; licensee BioMed Central Ltd. 2011 Modig et al; licensee BioMed Central Ltd.
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CorporateAuthor Family Medicine and Community Medicine
Allmänmedicin och samhällsmedicin
Faculty of Medicine
Lunds universitet
Department of Clinical Sciences, Malmö
Medicinska fakulteten
Lund University
Institutionen för kliniska vetenskaper, Malmö
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– reference: 19462255 - Pharm World Sci. 2009 Aug;31(4):481-6
– reference: 17575316 - Nephrol Dial Transplant. 2007 Oct;22(10):2894-9
– reference: 15189368 - J Intern Med. 2004 Jul;256(1):70-8
– reference: 16803468 - Br J Clin Pharmacol. 2007 Feb;63(2):136-47
– reference: 19517296 - Scand J Clin Lab Invest. 2009;69(5):606-11
– reference: 11040958 - Adv Clin Chem. 2000;35:63-99
– reference: 16970134 - Cleve Clin J Med. 2006 Sep;73(9):821-4, 826, 829-32 passim
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– reference: 11983211 - Clin Chim Acta. 2002 Jun;320(1-2):133-4
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– reference: 19414839 - Ann Intern Med. 2009 May 5;150(9):604-12
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– reference: 12930048 - Int J Qual Health Care. 2003 Aug;15(4):331-5
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– reference: 10460985 - Gerontology. 1999 Sep-Oct;45(5):243-53
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SSID ssj0017826
Score 1.9795169
Snippet Renal function decreases with age. Dosage adjustment according to renal function is indicated for many drugs, in order to avoid adverse reactions of...
Background Renal function decreases with age. Dosage adjustment according to renal function is indicated for many drugs, in order to avoid adverse reactions of...
Abstract Background: Renal function decreases with age. Dosage adjustment according to renal function is indicated for many drugs, in order to avoid adverse...
BACKGROUND: Renal function decreases with age. Dosage adjustment according to renal function is indicated for many drugs, in order to avoid adverse reactions...
Background Renal function decreases with age. Dosage adjustment according to renal function is   indicated for many drugs, in order to avoid adverse reactions...
Abstract Background Renal function decreases with age. Dosage adjustment according to renal function is indicated for many drugs, in order to avoid adverse...
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StartPage 1
SubjectTerms Aged
Aged, 80 and over
Analysis
Angiotensin-Converting Enzyme Inhibitors - pharmacokinetics
Angiotensin-Converting Enzyme Inhibitors - pharmacology
Anti-Arrhythmia Agents - administration & dosage
Anti-Inflammatory Agents, Non-Steroidal - pharmacokinetics
Clinical Medicine
Cohort Studies
Comorbidity
Creatinine - blood
Cystatin C - blood
Dermatologi och venerologi, klinisk genetik, invärtesmedicin
Dermatology and venerology,clinical genetics, internal medicine
Diabetes
Digoxin - administration & dosage
Drug therapy
drugs elderly nursing homes
Female
Frailty
Geriatric Assessment
Geriatrics
Geriatrics and medical gerontology
Geriatrik
Geriatrik och medicinsk gerontologi
Glomerular Filtration Rate - drug effects
Glomerular Filtration Rate - physiology
Health aspects
Humans
Internal medicine
Invärtesmedicin
Kidney - drug effects
Kidney - metabolism
Kidney diseases
Kidney Function Tests
Kidneys
Klinisk medicin
Male
Medical and Health Sciences
MEDICIN
Medicin och hälsovetenskap
MEDICINE
Nursing home patients
Nursing Homes
Patient outcomes
Renal Insufficiency - diagnosis
Renal Insufficiency - epidemiology
Renal Insufficiency - metabolism
Studies
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Title The assessment of renal function in relation to the use of drugs in elderly in nursing homes; a cohort study
URI https://www.ncbi.nlm.nih.gov/pubmed/21223578
https://www.proquest.com/docview/902107763
https://www.proquest.com/docview/847434750
http://dx.doi.org/10.1186/1471-2318-11-1
https://pubmed.ncbi.nlm.nih.gov/PMC3025849
https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-75552
https://lup.lub.lu.se/record/1777588
oai:portal.research.lu.se:publications/77c63467-97e0-45c8-8672-f1921feead0b
https://doaj.org/article/c5358575c07649ff87d02eed27ae20ed
Volume 11
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