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|Title:||Prescribing for older people with chronic renal impairment|
|Citation:||Australian Family Physician, 2013; 42(1):24-28|
|Publisher:||Royal Australian College of General Practitioners|
|J Simon Bell, Natalie Blacker, V Tammy LeBlanc, Christopher P Alderman, Adam Phillips, Debra Rowett, Simone Rossi, Oliver Frank, Alan Husband|
|Abstract:||Background: Renal function is an important prescribing consideration. On average, glomerular filtration rate declines by about 10 mL/min every 10 years after the age of 40. Renal impairment may cause medicines to accumulate or cause toxicity, especially if the medicine has a narrow therapeutic index. Objective: To present an overview of prescribing considerations in the primary care setting for patients with chronic renal impairment. Discussion: Serum creatinine considered in isolation is not a reliable indicator of renal function. The estimated glomerular filtration rate provided in pathology reporting can alert prescribers to possible renal impairment and the need to consider dose adjustments. The Cockcroft-Gault equation should be used to adjust medicine doses. Renal function monitoring is recommended for patients using medicines that can impair renal function or cause nephrotoxicity (eg. NSAIDs, ACEIs, ARBs).|
|Keywords:||renal insufficiency; aged; pharmaceutical preparations/ administration and dosage|
|Rights:||This article is copyright to the Australian Government Department of Veterans’ Affairs.|
|Appears in Collections:||General Practice publications|
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