De-indexed estimated glomerular filtration rates for the dosing of oral antidiabetic drugs in patients with chronic kidney disease Article Swipe
Maxime Pluquet
,
Marie Metzger
,
Christian Jacquelinet
,
Christian Combe
,
Denis Fouque
,
Maurice Laville
,
Luc Frimat
,
Ziad A. Massy
,
Sophie Liabeuf
,
Solène M. Laville
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.3389/fphar.2024.1375838
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.3389/fphar.2024.1375838
Introduction: Adjusting drug dose levels based on equations that standardize the estimated glomerular filtration rate (eGFR) to a body surface area (BSA) of 1.73 m 2 can pose challenges, especially for patients with extremely high or low body mass index (BMI). The objective of the present study of patients with CKD and diabetes was to assess the impact of deindexing creatinine-based equations on estimates of kidney function and on the frequency of inappropriate prescriptions of oral antidiabetic drugs (OADs). Methods: The prospective CKD-REIN cohort is comprised of patients with eGFR <60 mL/min/1.73 m 2 . The inclusion criteria for this study were the use of OADs and the availability of data on weight, height and serum creatinine. We compared data for three BMI subgroups (group 1 <30 kg/m 2 ; group 2 30–34.9 kg/m 2 ; group 3 ≥35 kg/m 2 ). Inappropriate prescriptions (contraindicated or over-dosed drugs) were assessed with regard to the summary of product characteristics and the patient’s kidney function estimated with the 2009 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, the 2021 CKD-EPI equation, the Modification of Diet in Renal Disease (MDRD) equation, the European Kidney Function Consortium (EKFC) equation, their deindexed estimates, and the Cockcroft-Gault (CG) formula. The impact of deindexing the equations was evaluated by assessing 1) the difference between the indexed and deindexed eGFRs, and 2) the difference in the proportion of patients with at least one inappropriate OAD prescription between the indexed and deindexed estimates. Results: At baseline, 694 patients were receiving OADs. The median BMI was 30.7 kg/m 2 , the mean BSA was 1.98 m 2 , and 90% of patients had a BSA >1.73 m 2 . Deindexing the kidney function estimates led to higher eGFRs, especially in BMI group 3. The proportion of patients with at least one inappropriate prescription differed greatly when comparing indexed and deindexed estimates. The magnitude of the difference increased with the BMI: when comparing BMI group 1 with BMI group 3, the difference was respectively −4% and −10% between deindexed 2021 CKD-EPI and indexed CKD-EPI. Metformin and sitagliptin were the most frequent inappropriately prescribed OADs. Conclusion: We highlight significant differences between the BSA-indexed and deindexed versions of equations used to estimate kidney function, emphasizing the importance of using deindexed estimates to adjust drug dose levels - especially in patients with an extreme BMI.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.3389/fphar.2024.1375838
- https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2024.1375838/pdf
- OA Status
- gold
- Cited By
- 1
- References
- 36
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4400332719
All OpenAlex metadata
Raw OpenAlex JSON
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https://openalex.org/W4400332719Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.3389/fphar.2024.1375838Digital Object Identifier
- Title
-
De-indexed estimated glomerular filtration rates for the dosing of oral antidiabetic drugs in patients with chronic kidney diseaseWork title
- Type
-
articleOpenAlex work type
- Language
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enPrimary language
- Publication year
-
2024Year of publication
- Publication date
-
2024-07-04Full publication date if available
- Authors
-
Maxime Pluquet, Marie Metzger, Christian Jacquelinet, Christian Combe, Denis Fouque, Maurice Laville, Luc Frimat, Ziad A. Massy, Sophie Liabeuf, Solène M. LavilleList of authors in order
- Landing page
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https://doi.org/10.3389/fphar.2024.1375838Publisher landing page
- PDF URL
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https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2024.1375838/pdfDirect link to full text PDF
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YesWhether a free full text is available
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-
goldOpen access status per OpenAlex
- OA URL
-
https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2024.1375838/pdfDirect OA link when available
- Concepts
-
Renal function, Medicine, Kidney disease, Creatinine, Dosing, Body surface area, Medical prescription, Body mass index, Urology, Internal medicine, Diabetes mellitus, Cohort, Endocrinology, PharmacologyTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
1Total citation count in OpenAlex
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2025: 1Per-year citation counts (last 5 years)
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36Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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