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...

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Autores principales: Aakjær, Mia, Houlind, Morten B., Treldal, Charlotte, Ankarfeldt, Mikkel Z., S. Jensen, Pia, Andersen, Ove, Iversen, Esben, Christrup, Lona L., Petersen, Janne
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
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.
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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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