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Renal impairment and medication: DISCUSSION(1)

Renal impairment and medication: DISCUSSION(1)

The prevalence of renal impairment in this study, using CCr as the criterion, was 35%. This proportion is in sharp contrast with a prevalence of less than 10% among community-dwelling adults, and less than 20% among those aged 80 years or older . However, the authors used the Cockcroft and Gault equation to determine renal function; the prevalence was 6% using SCr levels. On the other hand, the prevalence reported here was less than recent prevalence estimates from long term care facilities . Although both studies used CCr, our sample population was younger. Given that renal function decreases with age , a difference was anticipated. buy flovent inhaler

The authors obtained poor concordance between estimates of renal function based on SCr levels and CCr data. Although the correlation between both measures was 0.50, the percentage of the variance common to both variables amounted to only 25%. Kappa, the measure of agreement, showed a poor relationship between the determination of renal impairment by SCr levels and CCr data. Although some researchers have debated the merits of CCr , many have consistently suggested that the evaluation of renal clearance with the Cockcroft and Gault equation represents an appropriate and easy method to obtain a valid index of renal function . We recommend the use of CCr over SCr levels in older psychiatric patients.

Category: Psychogeriatric inpatients

Tags: Creatinine clearance, Medication use, Older adults, renal function, Serum creatinine

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