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2004, 97: 281-287. Kappa values < 0.4 were considered as low agreement, values between 0.4 to 0.59 as moderate, 0.6 to 0.74 as good and higher as very good agreement.A total of 108 patients, 73% female with a mean age of 85 years, were included in the study.
It is essential that kidney function is assessed correctly and that drug doses are adjusted according to kidney function. 0000052833 00000 n
All authors point out that they are referring to the newest evidence. 2007, 27: 197-205. We recruited practices by sending a letter of inquiry to the 120 teaching practices associated to the Insitute of General Practice at the Technical University Munich. If clinically indicated, the dose may be increased by a maximum of 600 mg/day at approximately weekly intervals; the maximum recommended daily dose is 1200 mg/day. 2007, 40: 383-391. 0000003668 00000 n
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The renal function should be monitored regularly in patients receiving therapy. Olanzapine Because olanzapine is highly metabolized before excretion and only 7% of the drug is excreted unchanged, renal dysfunction alone is unlikely to have a major impact on the … This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( 0000001896 00000 n
We examined patients at eighty years of age and older because multimorbidity, polypharmacy and renal impairment are common in this group of patients and, according to literature, it remains unclear which eGFR-estimation is suitable for estimating kidney function. According to two meta-analyses the diagnostic accuracy of cystatin C for impaired renal function ranges between slightly and clearly better than the diagnostic accuracy of creatinine [For patients with impaired renal function, changes in drug prescription are required. Clin Chem. 10.1681/ASN.2004070549.Laterza OF, Price CP, Scott MG: Cystatin C: an improved estimator of glomerular filtration rate?. 1.
9,10 The review by Trompeter 11 predates the dramatic increase in use of psychoactive medications for children with a variety of internalizing and externalizing behavioral … Therefore kidney function must not be overestimated. 10.1373/clinchem.2005.051557.Perkins BA, Nelson RG, Ostrander BE, Blouch KL, Krolewski AS, Myers BD, et al: Detection of renal function decline in patients with diabetes and normal or elevated GFR by serial measurements of serum cystatin C concentration: results of a 4-year follow-up study. 0000008599 00000 n
It seems rational to use country related references as they are the most likely to coincide with national guidelines.A strength of our study is that it was conducted under conditions of routine practice and focused on the consequences for the daily work of a family physician. Patient data was summarized descriptively (percentage, mean, median standard deviations and minimum/maximum). In addition, body height, weight, prescribed medication and diagnoses (coded according to the International Classification of Diseases (ICD)) were collected as documented in the physicians’ patient chart.
Further research on estimation of GFR and the development of an international consensus on concordant recommendations for practitioners concerning drug dose adjustment in renal failure are desirable.Corsonello A, Pedone C, Corica F, Mussi C, Carbonin P, Antonelli Incalzi R: Concealed renal insufficiency and adverse drug reactions in elderly hospitalized patients. Essential changes in drug doses or discontinuation of medication were documented and compared in terms of estimated renal function as a consequence of the different eGFR-equations using five references commonly used in the US, Great Britain and Germany.In general, creatinine-based equations resulted in lower eGFR-estimation and in higher necessity of drug dose adjustment than cystatin C-based equations. 0000025551 00000 n
2007, 36: 689-692. 2010, 39: 542-548.
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