Does routine estimated glomerular filtration rate reporting adversely affect medication dosing in an older population?

Historically, Cockcroft-Gault (CG) estimated creatinine clearance (eCrCl) was recommended for drug dosing in the presence of kidney disease, but standard pathology reports only include estimated glomerular filtration rate (eGFR). This single-centre retrospective cohort study of 162 patients ≥65 years old examined whether drug dosing errors occurred more commonly when using eGFR versus eCrCl. Of just over 200 medications requiring dose adjustment for GFR, one in eight had a potential prescribing error regardless of the method of estimating GFR. Use of CKD-EPI eGFR rather than CG eCrCl explained only a minority of potential prescribing errors, with no observed clinical consequences.

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Publication Details

Journal
Internal Medicine Journal
Published
2025-10-31
DOI
https://doi.org/10.1111/imj.70229
Primary Topic
Chronic Kidney Disease and Diabetes
Type
article
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article

Does routine estimated glomerular filtration rate reporting adversely affect medication dosing in an older population?

Brendan Smyth, Gina Davis, Mark Brown, Matthew Kinchington
Internal Medicine Journal
Chronic Kidney Disease and Diabetes
article

Does routine estimated glomerular filtration rate reporting adversely affect medication dosing in an older population?

Brendan Smyth, Gina Davis, Mark Brown, Matthew Kinchington
article en

Abstract

Historically, Cockcroft-Gault (CG) estimated creatinine clearance (eCrCl) was recommended for drug dosing in the presence of kidney disease, but standard pathology reports only include estimated glomerular filtration rate (eGFR). This single-centre retrospective cohort study of 162 patients ≥65 years old examined whether drug dosing errors occurred more commonly when using eGFR versus eCrCl. Of just over 200 medications requiring dose adjustment for GFR, one in eight had a potential prescribing error regardless of the method of estimating GFR. Use of CKD-EPI eGFR rather than CG eCrCl explained only a minority of potential prescribing errors, with no observed clinical consequences.

Internal Medicine JournalVol. 56(1)
The University of Sydney (AU), New South Wales Department of Health (AU), UNSW Sydney (AU), Prince of Wales Hospital (AU), St George Hospital (AU), Port Macquarie Base Hospital (AU), National Health and Medical Research Council (AU)
Openalex Percentile: Top 63%
Chronic Kidney Disease and Diabetes
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Does routine estimated glomerular filtration rate reporting adversely affect medication dosing in an older population? — Brendan Smyth, Gina Davis, et al. · Internal Medicine Journal (2025) | TGRS Research Map | TGRS