Skip Navigation


Age and Ageing Advance Access originally published online on September 19, 2009
Age and Ageing 2009 38(6):698-703; doi:10.1093/ageing/afp168
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Supplementary Data
Right arrow All Versions of this Article:
38/6/698    most recent
afp168v1
Right arrow E-Letters: Submit a response to the article
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Roberts, G. W.
Right arrow Articles by Schiøler, C. T.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Roberts, G. W.
Right arrow Articles by Schiøler, C. T.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author 2009. Published by Oxford University Press [on behalf of the British Geriatrics Society]. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Modified diet in renal disease method overestimates renal function in selected elderly patients*

Gregory William Roberts1, Pernille Maria Ibsen2 and Charlotte Teglman Schiøler2

1 Pharmacy Department, Repatriation General Hospital, Daw Park, SA 5041, Australia
2 Danish University of Pharmaceutical Sciences, Copenhagen, Denmark

Address correspondence to: G. W. Roberts. Tel: (+61) 8 82751632; Fax: (+61) 8 83740225. Email: Greg.Roberts2{at}health.sa.gov.au

Background: the Modification of Diet in Renal Disease (MDRD) method of renal function estimation has not been extensively assessed in elderly patients. We needed to assess which renal function estimate was most suited for drug dose estimation in our population.

Method: we compared MDRD with an optimised version of the Cockcroft–Gault (CGopt) method in a hospital population, using gentamicin clearance as a baseline.

Results: MDRD overestimated gentamicin clearance by 29% (P < 0.001, n = 68), while CGopt underestimated by 10% (P < 0.01). Overestimation by MDRD increased with increasing age. This was 12%, 26% and 69% in age groups <65, 65–80 and >80 years respectively (P < 0.001). CGopt underestimated renal function by –5%, –16% and –4% respectively (P = NS). Bias and precision of renal function estimations for the three age groups were less for CGopt than for MDRD. Age significantly influenced MDRD overestimation in this population (P = 0.037).

Conclusion: MDRD overestimated renal function as age increased. While CGopt underestimated renal function, this was of a smaller magnitude, consistent across age, and thus better suited for dose calculation, especially in the elderly. Larger-scale studies using gold standard markers of renal function estimation are urgently needed to determine the accuracy of MDRD in elderly hospitalised patients.

Keywords: elderly, creatinine, gentamicin, drug dosing

*Institutions where study performed

1. Repatriation General Hospital, Daw Park, SA 5041, Australia

2. Flinders Medical Centre, Bedford Park, SA 5041, Australia

Received 5 February 2009; accepted in revised form 8 July 2009.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.