Prescribing for older people with chronic renal impairment
Date
2013
Authors
Bell, J.S.
Blacker, N.
LeBlanc, V.T.
Alderman, C.P.
Phillips, A.
Rowett, D.
Rossi, S.
Frank, O.
Husband, A.
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Journal article
Citation
Australian Family Physician, 2013; 42(1):24-28
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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).
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Copyright 2013 Australian Government Department of Veterans' Affairs