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Related Experiment Videos

Difficulties in estimating glomerular filtration rate in the elderly.

T H Goldberg, M S Finkelstein

    Archives of Internal Medicine
    |August 1, 1987
    PubMed
    Summary

    Estimating glomerular filtration rate (GFR) is challenging due to unreliable urine collections and formulas. Measuring drug levels is recommended for elderly patients and those with renal insufficiency.

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    Area of Science:

    • Nephrology
    • Clinical Pharmacology
    • Geriatrics

    Background:

    • Glomerular filtration rate (GFR) estimation is crucial for clinical decisions, often relying on creatinine clearance.
    • Accurate GFR assessment can be hindered by difficulties in obtaining reliable urine samples.
    • Existing predictive formulas for GFR may have limitations in accuracy.

    Purpose of the Study:

    • To evaluate the reliability of estimating creatinine clearance from serum creatinine levels using the Cockcroft-Gault equation.
    • To assess the feasibility of obtaining satisfactory 24-hour urine collections in elderly outpatients.

    Main Methods:

    • Comparison of measured 24-hour creatinine clearance with values calculated by the Cockcroft-Gault equation in 50 inpatients.
    • Assessment of 24-hour urine collection success rates in 19 healthy elderly outpatients.

    Main Results:

    • A moderate correlation was observed between measured and calculated creatinine clearance, potentially insufficient for clinical use.
    • A significant number of elderly outpatients were unable to provide adequate 24-hour urine collections.

    Conclusions:

    • Current bedside methods for estimating GFR, including predictive formulas and urine collection, are unreliable, especially in the elderly and renally impaired.
    • Direct measurement of drug levels is advised in elderly patients and those with renal insufficiency due to GFR estimation uncertainties.

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