ArticleNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2011
Inappropriate drug use and mortality in community-dwelling elderly with impaired kidney function--the Three-City population-based study.
Article in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 1 of them a synthesis that pooled it.
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Who cites it
44 citing papers in PubMed, 1 synthesis or guideline pooled it, 101 citations in OpenAlex.
- Drug-Related Problems in Hospitalised Patients with Chronic Kidney Disease: A Systematic Review.Drug safety · 2021Pooled it
- Prevalence and Management of Drug-Related Problems in Chronic Kidney Disease Patients by Severity Level: A Subanalysis of a Cluster Randomized Controlled Trial in Community Pharmacies.Journal of managed care & specialty pharmacy · 2018Trial
- Widespread inappropriate prescribing for older people with reduced kidney function: what are the harms and how do we tackle them? A scoping review for primary care.BMJ quality & safety · 2026Article
- Creatinine clearance, reduced kidney function, and optimizing prescribing safety through practice feedback: a mixed methods study.Family practice · 2025Article
- Ten-Year Trend in the Potentially Inappropriate Prescribing of Renally-Dependent Medicines in Australian General Practice Patients with Dementia.Journal of clinical medicine · 2025Article
- Effect of a Population Health Management Intervention on Medication Therapy Problems in People With Chronic Kidney Disease: Post Hoc Analysis of the K-CHAMP Cluster-Randomized Trial.Kidney medicine · 2025Article
- A clinical decision support system promotes the appropriate use of drugs in hospitalized patients with kidney impairment.Journal of pharmaceutical health care and sciences · 2025Review
- Review
- Hypoglycemia risk with inappropriate dosing of glucose-lowering drugs in patients with chronic kidney disease: a retrospective cohort study.Scientific reports · 2023Article
- Appropriateness of drug prescriptions in patients with chronic kidney disease in primary care: a double-center retrospective study.BMC primary care · 2022Observational
- Deprescribing Opportunities for Hospitalized Patients With End-Stage Kidney Disease on Hemodialysis: A Secondary Analysis of the MedSafer Cluster Randomized Controlled Trial.Canadian journal of kidney health and disease · 2022Article
- Using Machine Learning to Identify Patients at High Risk of Inappropriate Drug Dosing in Periods with Renal Dysfunction.Clinical epidemiology · 2022Article
- Association between a low dose of proton pump inhibitors and kidney function decline in elderly hypertensive patients: a retrospective observational study.The Journal of international medical research · 2021Observational
- Utilization of potentially inappropriate medication and risk of adverse drug events among older adults with chronic renal insufficiency: a population-wide cohort study.BMC geriatrics · 2021Article
- A Novel Creatinine-Based Equation to Estimate Glomerular Filtration Rate in Chinese Population With Chronic Kidney Disease: Implications for DOACs Dosing in Atrial Fibrillation Patients.Frontiers in pharmacology · 2021Article
- Correct use of non-indexed eGFR for drug dosing and renal drug-related problems at hospital admission.European journal of clinical pharmacology · 2020Observational
- Potentially inappropriate medications prescribing to elderly patients with advanced chronic kidney by using 2019 American Geriatrics Society Beers Criteria.Health science reports · 2020Article
- The Role of Community Pharmacists in the Detection of Clinically Relevant Drug-Related Problems in Chronic Kidney Disease Patients.Pharmacy (Basel, Switzerland) · 2020Article
- Adverse Drug Events in Patients with Chronic Kidney Disease Associated with Multiple Drug Interactions and Polypharmacy.Drugs & aging · 2020Observational
- Medication burden and inappropriate prescription risk among elderly with advanced chronic kidney disease.BMC geriatrics · 2020Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGlomerular filtration rate (GFR) decline with age increases the risk of inappropriate dosing of drugs. We investigated the determinants and the mortality associated with the use of drugs that are contraindicated or require dose adjustment according to kidney function among the community-dwelling elderly.
methodsThe Three-City population-based study included 8701 participants ≥65 years from 1999 to 2001. Exposure to the risk of inappropriate drug dosage was defined as reported use of either a contraindicated drug or one requiring dose adjustment according to the individual baseline glomerular filtration rate estimated (eGFR) with the Modification of Diet in Renal disease study equation. Six-year mortality was analysed using Cox models adjusted for several sociodemographic, biologic and clinical risk factors.
resultsThe overall percentage of exposure to the risk of inappropriate drug use was 13.3% (contraindication, 0.8%): it was 52.5% (4.5%) in those with an eGFR of 30-59 and 96% (48%) in those <30 mL/min/1.73 m(2). Antihypertensive agents, fibrates and psycholeptics accounted for most of the drugs with dosing recommendations and antidiabetic agents and antihistamines for those contraindicated. Individuals at risk were more likely to be men, older, and under treatment for hypertension or hypercholesterolemia. Exposure to either risk was independently related to higher all-cause mortality (hazard ratio 1.4, 95% confidence interval 1.0-1.9) in participants with eGFR <60 mL/min/1.73 m(2).
conclusionsContraindicated drug prescription was uncommon but >10% of the population took drugs requiring renal dosing adjustments. Regular monitoring of eGFR may prevent excess mortality associated with inappropriate drug prescription in the elderly.
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