2016
DOI: 10.1007/s00228-016-2113-2
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Drug therapy management in patients with renal impairment: how to use creatinine-based formulas in clinical practice

Abstract: PurposeThe use of estimated glomerular filtration rate (eGFR) in daily clinical practice.MethodseGFR is a key component in drug therapy management (DTM) in patients with renal impairment. eGFR is routinely reported by laboratories whenever a serum creatinine testing is ordered. In this paper, we will discuss how to use eGFR knowing the limitations of serum creatinine-based formulas.ResultsBefore starting a renally excreted drug, an equally effective drug which can be used more safely in patients with renal imp… Show more

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Cited by 19 publications
(20 citation statements)
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“…Overall, the two major routes of drug elimination are kidney and liver. For drugs primarily excreted by the kidneys unchanged or as active metabolites, prescribing recommendations are influenced by kidney function . The rate of dosing discrepancies for CKD‐EPI Cr and CG Cr in our study population is high but consistent with existing literature regarding prescribing practices in the elderly .…”
Section: Discussionsupporting
confidence: 83%
“…Overall, the two major routes of drug elimination are kidney and liver. For drugs primarily excreted by the kidneys unchanged or as active metabolites, prescribing recommendations are influenced by kidney function . The rate of dosing discrepancies for CKD‐EPI Cr and CG Cr in our study population is high but consistent with existing literature regarding prescribing practices in the elderly .…”
Section: Discussionsupporting
confidence: 83%
“…The guidelines were selected by a group of experts, including hospital pharmacists, clinical pharmacologists and hospital-based physicians in a consensus meeting. The selected guidelines had to relate to medication that has shown to frequently be involved in preventable, clinically relevant, drug-related problems [ 1 3 , 6 8 ]. All guidelines had to be part of a local implemented protocol in the hospital and were addressed in the educational program.…”
Section: Methodsmentioning
confidence: 99%
“…Many of these problems derive from prescribing errors that lead to potentially preventable morbidity, mortality and costs [ 5 ]. The majority of these are caused by pain medication, antithrombotics, antibacterial drugs, cardiovascular drugs, and drugs that are renally excreted [ 1 3 , 6 9 ].…”
Section: Introductionmentioning
confidence: 99%
“…Moreover, the eGFR can be an underestimation or overestimation of the actual value. Formulas for estimating GFR should be applied carefully, and the patients’ individual characteristics should be taken into account [ 32 , 33 ]. Future CDSSs could be improved by incorporating historical trends in patients’ renal function and patient characteristics affecting GFR estimates in the algorithms.…”
Section: Discussionmentioning
confidence: 99%