Wong N A, Jones H W
Department of Geratology, Radcliffe Infirmary, Oxford, UK.
Postgrad Med J. 1998 Jul;74(873):420-2. doi: 10.1136/pgmj.74.873.420.
Renal impairment is common amongst elderly patients and increases the risk of drug toxicity. Analysis of the discharge summaries of patients discharged from the geratology wards of an Oxfordshire hospital, showed that renal impairment was not referred to in 42% of patients with calculated creatinine clearances of 10-20 ml/min. A fifth of these patients, and 67% of patients with calculated creatinine clearances < 10 ml/min, had discharge drug prescriptions that contradicted the British National Formulary guidelines for prescribing in the presence of renal impairment. There should be increased awareness that, in elderly patients, normal serum creatinine concentrations do not exclude renal impairment and that several commonly prescribed drugs require dose adjustments or should be avoided in the presence of renal insufficiency.
肾功能损害在老年患者中很常见，并且会增加药物毒性风险。对牛津郡一家医院老年病房出院患者的出院小结进行分析后发现，在估算肌酐清除率为10 - 20毫升/分钟的患者中，42%未提及肾功能损害。这些患者中有五分之一，以及估算肌酐清除率<10毫升/分钟的患者中有67%，其出院时的药物处方与《英国国家处方集》中关于肾功能损害时用药的指南相矛盾。应该提高认识，即在老年患者中，正常的血清肌酐浓度并不排除肾功能损害，并且在存在肾功能不全的情况下，几种常用药物需要调整剂量或应避免使用。
