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Journal de Pharmacie Clinique

Recognize renal insufficiency patient: evaluation of renal function Volume 30, numéro 4, Décembre 2011

  • Auteur(s) : Nicolas Janus , Service ICAR, Service de néphrologie, GHU Pitié-Salpêtrière, Paris
  • Mots-clés : renal insufficiency, estimation, evaluation, Cockcroft-Gault, aMDRD, CKD-EPI
  • Page(s) : 249-52
  • DOI : 10.1684/jpc.2011.0199
  • Année de parution : 2011

Renal insufficiency is frequent. It can lead to complications and have consequences for the handling of drugs in terms of dose adjustment or drug nephrotoxicity. Thus, its diagnosis and monitoring are essential. There are several methods to measure renal function. The first ones involve exogenous markers and complex techniques (51Cr-EDTA, iothalamate or iohexol). The others methods use an exogenous marker, serum creatinine. However, the value of serum creatinine should not be interpreted alone. Therafter, formulae for estimating kidney function incorporating serum creatinine have been developed. Among them we find the Cockcroft-Gault, MDRD formulae (then aMDRD) and more recently the CKD-EPI formula. However, these formulae are not equivalent. Indeed, the aMDRD formula is particularly effective in specific population, such as elderly patients, when compared with the Cockcroft-Gault formula. It is therefore important to be attentive to the patient profile before assessing kidney function with a formula for estimating renal function.