Kielstein J T, Keller F
Klinik für Nieren- und Hochdruckerkrankungen, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
Internist (Berl). 2012 Jul;53(7):802-9. doi: 10.1007/s00108-011-3011-4.
The number of patients suffering from chronic kidney disease (CKD) is increasing worldwide and exceeds 15% of the entire population in industrialized countries. Half of the patients aged 70 + years suffer from CKD. The most prevalent underlying diseases leading to CKD are diabetes and hypertension. CKD per se increases the risk of cardiovascular events, cancer, and infections; hence, adequate and intensified pharmacotherapy is of utmost importance in this patient population. About 60% of all regularly used drugs are excreted by the kidney. For those, dose adjustment is of utter importance to avoid untoward effects and serious complications. The first important step for dose adjustment is the accurate estimation of renal function, i.e., glomerular filtration rate (GFR). Renal function cannot be assessed by serum creatinine alone as it only rises after a substantial (> 50%) loss of glomerular function and depends on many factors, e.g., age, gender, weight, and race. GFR can easily be estimated using formulas, e.g., the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula.
