How reliable is eGFR when calculating drug dosage in acute medical admissions?

McNeil, G. B. S. and Martin, J. H. (2011) How reliable is eGFR when calculating drug dosage in acute medical admissions?. Internal Medicine Journal, 41 4: 327-331. doi:10.1111/j.1445-5994.2010.02307.x

Author McNeil, G. B. S.
Martin, J. H.
Title How reliable is eGFR when calculating drug dosage in acute medical admissions?
Journal name Internal Medicine Journal   Check publisher's open access policy
ISSN 1444-0903
Publication date 2011-04
Year available 2010
Sub-type Article (original research)
DOI 10.1111/j.1445-5994.2010.02307.x
Volume 41
Issue 4
Start page 327
End page 331
Total pages 5
Place of publication Richmond, Vic., Australia
Publisher Wiley-Blackwell Publishing Asia
Collection year 2012
Language eng
Formatted abstract
Background: The Modification of Diet in Renal Disease-derived estimation of glomerular filtration rate (eGFR) is used widely. Although validated in stable chronic kidney disease (CKD) outpatients, it is not known how it performs in those presenting with acute medical illness.
Aim: We aimed to compare eGFR with Cockroft Gault (CG) - the renal function assessment tool available prior to eGFR - to assess the difference in clinical outcome that would occur when one over another estimation is used in practice. In particular, we wished to assess whether use of eGFR would have resulted in a change of dose of commonly used acutely administered medications.
Methods: Acute medical admissions presenting to a tertiary hospital between August and December 2008 were included. Serum creatinine concentration, age, sex, height and weight were collected. Renal function was estimated by both estimates. Movement from CKD class 3 to 4 or 5 was measured - a clinically used cut-off point for changes in management.
Results: A total of 54 patients was included. eGFR values were higher than those estimated by CG. Almost half of patients categorized as CKD stage 4-5 using CG were only categorized as CKD stage 3 using eGFR.
Conclusion: Although we did not use a gold standard estimation of GFR, this study shows that estimates of renal function vary in a clinically significant manner. As estimates of GFR are used to adjust drug dosages and to stratify for many other treatments, it is imperative that we find a method of estimating kidney function that is readily available, consistent and accurate.
© 2011 The Authors. Internal Medicine Journal © 2011 Royal Australasian College of Physicians.
Keyword Acute renal failure
Glomerular filtration rate estimates
Acute disease
Drug dosage calculations
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Medicine Publications
UQ Diamantina Institute Publications
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Created: Tue, 07 Jun 2011, 14:59:27 EST by Dr Jennifer Martin on behalf of UQ Diamantina Institute