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Comparison of equations for dosing of medications in renal impairment

Khanal, A, Peterson, GM ORCID: 0000-0002-6764-3882, Jose, MD ORCID: 0000-0002-9589-0071 and Castelino, RL 2017 , 'Comparison of equations for dosing of medications in renal impairment' , Nephrology, vol. 22, no. 6 , pp. 470-477 , doi: 10.1111/nep.12834.

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Abstract

AIM:The aim of this study is to determine the concordance among the Cockcroft-Gault, the Modification of Diet in Renal Disease and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations in hypothetical dosing of renally cleared medications.METHODS:A total of 2163 patients prescribed at least one of the 31 renally cleared drugs under review were included in the study. Kidney function was estimated using the three equations. We compared actual prescribed dosages of the same drug with recommended dosages based on the kidney function as calculated by each of the equations and applying dosing recommendations in the Australian Medicines Handbook.RESULTS:There was a significant difference in the kidney function values estimated from the three equations (P CONCLUSIONS:There is need for a long-term multi-centre study in a diverse population to define the clinical effects of the discrepancies among the equations for drug dosing. Given the greater concordance of the non-normalized CKD-EPI equation with the Cockcroft-Gault equation for dosing, the recommendation by Kidney Health Australia and the United States National Kidney Disease Education Program that 'dosing based on either eCrCl or an eGFR with body surface area normalization removed are acceptable' seems suitable and practicable for the purpose of dosing of non-critical drugs in the primary care setting.

Item Type: Article
Authors/Creators:Khanal, A and Peterson, GM and Jose, MD and Castelino, RL
Keywords: Drug dosage kidney disease safety
Journal or Publication Title: Nephrology
Publisher: Blackwell Publishing Asia
ISSN: 1320-5358
DOI / ID Number: 10.1111/nep.12834
Copyright Information:

Copyright 2016 Asian Pacific Society of Nephrology

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