ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2018
Application of prescribing recommendations in older people with reduced kidney function: a cross-sectional study in general practice.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 16 citations in OpenAlex.
- 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
- Prolonged Suppression of Bacterial Growth in Urine Culture Following Fluoroquinolone Therapy in an Elderly Diabetic Patient: A Diagnostic Pitfall.Infection and drug resistance · 2026Article
- Creatinine clearance, reduced kidney function, and optimizing prescribing safety through practice feedback: a mixed methods study.Family practice · 2025Article
- Kidney Disease Aging Research Collaborative (KDARC): Addressing barriers in geriatric nephrology research.Journal of the American Geriatrics Society · 2025Article
- Hypocalcemia Event Associated with Denosumab: A Real-World Study from FDA Adverse Event Reporting System (FAERS) Database.Therapeutic innovation & regulatory science · 2025Article
- Article
- Pharmacological treatments and medication-related problems in nursing homes in Catalonia: a multidisciplinary approach.Frontiers in pharmacology · 2024Article
- Article
- Potentially inappropriate primary care prescribing in people with chronic kidney disease: a cross-sectional analysis of a large population cohort.The British journal of general practice : the journal of the Royal College of General Practitioners · 2021Article
- Creatinine clearance versus eGFR.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018Article
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4 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundKidney function reduces with age, increasing the risk of harm from increased blood levels of many medicines. Although estimated glomerular filtration rate (eGFR) is reported for prescribing decisions in those aged ≥65 years, creatinine clearance (Cockcroft-Gault) gives a more accurate estimate of kidney function.
aimTo explore the extent of prescribing outside recommendations for people aged ≥65 years with reduced kidney function in primary care and to assess the impact of using eGFR instead of creatinine clearance to calculate kidney function. DESIGN AND
settingA cross-sectional survey of anonymised prescribing data in people aged ≥65 years from all 80 general practices (70 900 patients) in a north of England former primary care trust.
methodThe prevalence of prescribing outside recommendations was analysed for eight exemplar drugs. Data were collected for age, sex, actual weight, serum creatinine, and eGFR. Kidney function as creatinine clearance (Cockcroft-Gault) was calculated using actual body weight and estimated ideal body weight.
resultsKidney function was too low for recommended prescribing in 4-40% of people aged ≥65 years, and in 24-80% of people aged ≥85 years despite more than 90% of patients having recent recorded kidney function results. Using eGFR overestimated kidney function for 3-28% of those aged ≥65 years, and for 13-58% of those aged ≥85 years. Increased age predicted higher odds of having a kidney function estimate too low for recommended prescribing of the study drugs.
conclusionPrescribing recommendations when kidney function is reduced are not applied for many people aged ≥65 years in primary care. Using eGFR considerably overestimates kidney function for prescribing and, therefore, creatinine clearance (Cockcroft-Gault) should be assessed when prescribing for these people. Interventions are needed to aid prescribers when kidney function is reduced.
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