Differences in Kidney Function Estimates Based on Creatinine and/or Cystatin C in Non-Traumatic Amputation Patients and Their Impact on Drug Prescribing
Accurate kidney function estimates are necessary when prescribing renally-eliminated medications. Our objectives were to investigate how amputation affects estimated glomerular filtration rate (eGFR) and to determine if dosing recommendations differ among different eGFR equations. In a cohort study...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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MDPI
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6351924/ https://www.ncbi.nlm.nih.gov/pubmed/30646571 http://dx.doi.org/10.3390/jcm8010089 |
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author | Aakjær, Mia Houlind, Morten B. Treldal, Charlotte Ankarfeldt, Mikkel Z. S. Jensen, Pia Andersen, Ove Iversen, Esben Christrup, Lona L. Petersen, Janne |
author_facet | Aakjær, Mia Houlind, Morten B. Treldal, Charlotte Ankarfeldt, Mikkel Z. S. Jensen, Pia Andersen, Ove Iversen, Esben Christrup, Lona L. Petersen, Janne |
author_sort | Aakjær, Mia |
collection | PubMed |
description | Accurate kidney function estimates are necessary when prescribing renally-eliminated medications. Our objectives were to investigate how amputation affects estimated glomerular filtration rate (eGFR) and to determine if dosing recommendations differ among different eGFR equations. In a cohort study of non-traumatic amputation patients, eGFR based on creatinine and/or cystatin C were measured before and after amputation. Prescribed, renally-eliminated medications were compared with dosing guidelines in Renbase(®). Data from 38 patients with a median age of 75 years were analyzed. The median (range) eGFR was 65 (15–103), 38 (13–79), and 48 (13–86) mL/min/1.73 m(2) before amputation and 80 (22–107), 51 (13–95), and 62 (16–100) mL/min/1.73 m(2) after amputation for eGFR(Creatinine), eGFR(CystatinC), and eGFR(Combined), respectively (p < 0.01). From before to after amputation, eGFR increased on average by 8.5, 6.1, and 7.4 mL/min/1.73 m(2) for eGFR(Creatinine), eGFR(CystatinC), and eGFR(Combined) (all p < 0.01), respectively. At least one renally-eliminated medication was prescribed at a higher dose than recommended in 37.8% of patients using eGFR(CystatinC), 17.6% using eGFR(Combined) and 10.8% using eGFR(Creatinine). In conclusion, amputation affects eGFR regardless of the eGFR equations. The differences among equations would impact prescribing of renally-eliminated medications, particularly when switching from creatinine to cystatin C. |
format | Online Article Text |
id | pubmed-6351924 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-63519242019-02-01 Differences in Kidney Function Estimates Based on Creatinine and/or Cystatin C in Non-Traumatic Amputation Patients and Their Impact on Drug Prescribing Aakjær, Mia Houlind, Morten B. Treldal, Charlotte Ankarfeldt, Mikkel Z. S. Jensen, Pia Andersen, Ove Iversen, Esben Christrup, Lona L. Petersen, Janne J Clin Med Article Accurate kidney function estimates are necessary when prescribing renally-eliminated medications. Our objectives were to investigate how amputation affects estimated glomerular filtration rate (eGFR) and to determine if dosing recommendations differ among different eGFR equations. In a cohort study of non-traumatic amputation patients, eGFR based on creatinine and/or cystatin C were measured before and after amputation. Prescribed, renally-eliminated medications were compared with dosing guidelines in Renbase(®). Data from 38 patients with a median age of 75 years were analyzed. The median (range) eGFR was 65 (15–103), 38 (13–79), and 48 (13–86) mL/min/1.73 m(2) before amputation and 80 (22–107), 51 (13–95), and 62 (16–100) mL/min/1.73 m(2) after amputation for eGFR(Creatinine), eGFR(CystatinC), and eGFR(Combined), respectively (p < 0.01). From before to after amputation, eGFR increased on average by 8.5, 6.1, and 7.4 mL/min/1.73 m(2) for eGFR(Creatinine), eGFR(CystatinC), and eGFR(Combined) (all p < 0.01), respectively. At least one renally-eliminated medication was prescribed at a higher dose than recommended in 37.8% of patients using eGFR(CystatinC), 17.6% using eGFR(Combined) and 10.8% using eGFR(Creatinine). In conclusion, amputation affects eGFR regardless of the eGFR equations. The differences among equations would impact prescribing of renally-eliminated medications, particularly when switching from creatinine to cystatin C. MDPI 2019-01-14 /pmc/articles/PMC6351924/ /pubmed/30646571 http://dx.doi.org/10.3390/jcm8010089 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Aakjær, Mia Houlind, Morten B. Treldal, Charlotte Ankarfeldt, Mikkel Z. S. Jensen, Pia Andersen, Ove Iversen, Esben Christrup, Lona L. Petersen, Janne Differences in Kidney Function Estimates Based on Creatinine and/or Cystatin C in Non-Traumatic Amputation Patients and Their Impact on Drug Prescribing |
title | Differences in Kidney Function Estimates Based on Creatinine and/or Cystatin C in Non-Traumatic Amputation Patients and Their Impact on Drug Prescribing |
title_full | Differences in Kidney Function Estimates Based on Creatinine and/or Cystatin C in Non-Traumatic Amputation Patients and Their Impact on Drug Prescribing |
title_fullStr | Differences in Kidney Function Estimates Based on Creatinine and/or Cystatin C in Non-Traumatic Amputation Patients and Their Impact on Drug Prescribing |
title_full_unstemmed | Differences in Kidney Function Estimates Based on Creatinine and/or Cystatin C in Non-Traumatic Amputation Patients and Their Impact on Drug Prescribing |
title_short | Differences in Kidney Function Estimates Based on Creatinine and/or Cystatin C in Non-Traumatic Amputation Patients and Their Impact on Drug Prescribing |
title_sort | differences in kidney function estimates based on creatinine and/or cystatin c in non-traumatic amputation patients and their impact on drug prescribing |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6351924/ https://www.ncbi.nlm.nih.gov/pubmed/30646571 http://dx.doi.org/10.3390/jcm8010089 |
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