Prescribing for older people with chronic renal impairment

J Simon Bell, Natalie Blacker, V. Tammy LeBlanc, Christopher P. Alderman, Adam Phillips, Debra Rowett, Simone Rossi, Oliver Frank, Alan J Husband

Research output: Contribution to journalArticleResearchpeer-review

24 Citations (Scopus)


Background: Renal function is an important prescribing consideration. On average, glomerular filtration rate declines by about 10 mL/min every 10 years after the age of 40. Renal impairment may cause medicines to accumulate or cause toxicity, especially if the medicine has a narrow therapeutic index. 

Objective: To present an overview of prescribing considerations in the primary care setting for patients with chronic renal impairment. 

Discussion: Serum creatinine considered in isolation is not a reliable indicator of renal function. The estimated glomerular filtration rate provided in pathology reporting can alert prescribers to possible renal impairment and the need to consider dose adjustments. The Cockcroft-Gault equation should be used to adjust medicine doses. Renal function monitoring is recommended for patients using medicines that can impair renal function or cause nephrotoxicity (eg. NSAIDs, ACEIs, ARBs).

Original languageEnglish
Pages (from-to)24-28
Number of pages5
JournalAustralian Family Physician
Issue number1
Publication statusPublished - Jan 2013
Externally publishedYes


  • Aged
  • Pharmaceutical preparations/ administration and dosage
  • Renal insufficiency

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