Original Research
Tuesday, October 15, 2024
08:30 AM–10:00 AM
Abstract
Introduction: Numerous equations have been developed to estimate kidney function. The most notable and frequently used for drug dosing is the Cockcroft-Gault (CG) equation and to lesser extent the Modification of Diet in Renal Disease (MDRD) and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations. Recently the CKD-EPI raceless equation has been advocated for use.
Research Question or Hypothesis: The CKD-EPI raceless equation has been widely adopted by institutions for use, whereas individualized equations are specifically utilized for patients with extreme body weights to ensure accurate assessments.
Study Design: Observational real-time survey analysis
Methods: A survey was distributed to list serves utilized by pharmacists within the USA and internationally between January and April 2024. Respondents had the option to skip questions. The study received an exemption from the Loma Linda University Institutional Review Board.
Results: Out of the 294 pharmacists who participated in the survey, 134 (76.1%) were based in the USA, and 107 (60.5%) were female. Of the respondents, 211 (72.3%) indicated that their institution has a kidney dose adjustment policy with the majority utilizing CG. A total of 149 (60.3%) of respondents indicated that they were unaware if their institution used standardized serum creatinine analysis methodology. Additionally, 88 (38.1%) reported rounding up serum creatinine in the elderly when utilizing CG, with 47 (53.4%) of those rounding, rounding it up to 1 mg/dL. Only 49 (21.8%) of pharmacists indicated that they individualize the eGFR for patients with extreme weights.
Conclusion: There is no consistent practice in selecting the appropriate equation for drug dosing in patients with kidney disease in the US and internationally. Extensive education on the different kidney function estimation equations and a recommendation for standardization is necessary to optimize patient care and application of evidence-based medicine.
Presenting Author
Branden D Nemecek PharmD, BCPSDuquesne University
Authors
Erica Anderson PharmD
Atrium Health Wake Forest Baptist Medical Center
Wasim Elnekidy PharmD, BCPS, BCACP
Cleveland Clinic Abu Dhabi
Lisa Hong PharmD, BCPS
Loma Linda University
Wendy St. Peter Pharm.D.
University of Minnesota College of Pharmacy