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

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.