Agreement between equations estimating glomerular filtration rate in elderly nursing home residents and in hospitalised patients: Implications for drug dosing

Andrea Corsonello, Claudio Pedone, Fabrizia Lattanzio, Roberto Semeraro, Francesco D'Andria, Maurizio Gigante, Anna Coppola, Giancarlo Cadeddu, Irma Laino, Raffaele Antonelli Incalzi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: detecting chronic kidney disease (CKD) may have important implications for the management of older and frail people. We aimed at investigating whether clinical setting (nursing home: NH versus hospital: H) affects the agreement between glomerular filtration rate (GFR) values estimated by Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI), Cockcroft-Gault (CG) and Modification of Diet in Renal Disease (MDRD) equations. Design: observational study. Setting: comparison between NH residents and H patients. Subjects: we used data from 177 NH residents, and 439 H patients. Methods: the agreement between estimating equations and the odds of a discrepancy >25% between formulas in relation to setting (NH versus H) were investigated. Results: the agreement between MDRD and CKD-EPI formulas was good either in NH (k = 0.82) or H (k = 0.87) patients, while corresponding figures for CG indicate only a fair agreement with CKD-EPI (k = 0.50 for both populations). Setting (NH versus H) was associated with discordance between MDRD and CKD-EPI (OR = 3.97; 95% CI = 1.75-9.01), but not between CG and EPI (OR = 1.25; 95% CI = 0.87-1.81). Conclusions: in NH residents, MDRD and CKD-EPI formulas yield highly concordant GFR values, but CG behaves differently in up to one-third of patients. Such findings have important implications in dosing drugs cleared by the kidney. Setting should be taken into consideration in studies for validation of GFR equations.

Original languageEnglish
Article numberafr011
Pages (from-to)583-589
Number of pages7
JournalAge and Ageing
Volume40
Issue number5
DOIs
Publication statusPublished - Sep 2011

Keywords

  • Drugs
  • Elderly
  • Glomerular filtration rate
  • Hospital
  • Nursing home

ASJC Scopus subject areas

  • Ageing
  • Geriatrics and Gerontology

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