Related Experiment Video
Updated: Jun 28, 2026
08:50
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Assessment of renal function in elderly patients
1Department of Internal Medicine IV, Renal and Hypertensive Disease, Saarland University Medical Centre, Homburg/Saar, Germany. indfli@uks.eu
Current Opinion in Nephrology and Hypertension
|October 23, 2008
Summary
Accurate kidney function monitoring is crucial for the elderly. Serum creatinine is unreliable; use methods like the Modification of Diet in Renal Disease formula or cystatin C for better glomerular filtration rate assessment.
Area of Science:
- Gerontology
- Nephrology
- Clinical Medicine
Background:
- The global elderly population is rapidly expanding.
- Chronic kidney disease (CKD) incidence increases with age.
- Accurate glomerular filtration rate (GFR) monitoring is vital for early CKD detection in older adults.
Purpose of the Study:
- To review current GFR assessment methods.
- To evaluate the utility of these methods in the elderly population.
- To highlight the importance of precise renal function assessment in aging individuals.
Main Methods:
- Review of existing literature on GFR assessment techniques.
- Analysis of the reliability of serum creatinine and alternative markers.
- Evaluation of GFR estimation equations and clearance methods.
Main Results:
- Serum creatinine is an unreliable GFR indicator in the elderly, especially if ill or malnourished.
- Timed creatinine clearance, Modification of Diet in Renal Disease (MDRD) formula, and serum cystatin C offer more reliable GFR estimates.
- No single method is universally satisfactory for all elderly patients.
Conclusions:
- Accurate GFR assessment is essential for managing elderly individuals at risk of CKD.
- The MDRD formula is generally recommended, with cystatin C or isotope clearance as alternatives when MDRD reliability is questionable.
- Precise renal function evaluation aids in managing conditions like diabetes and hypertension that accelerate age-related GFR decline.
Related Concept Videos
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
01:17Factors Affecting Renal Clearance: Renal Impairment
Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
01:28Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration
Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area. This equation is...
01:15Drug Dosing: Geriatric Patients
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
01:25Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant
In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
01:24Serum Studies: Renal Function Tests
Renal function tests are crucial for assessing kidney health, monitoring disease progression, and evaluating the kidneys' efficiency in waste elimination, fluid balance, and electrolyte regulation. These tests offer critical insights into kidney function, even though routine measurements may appear normal until there is a significant decline in the glomerular filtration rate or GFR. Typically, signs of kidney impairment only become evident when the GFR falls to about 50% of its normal level.