[Hidden renal failure and drug prescription in hospitalized patients].

Abstract

Objective: Equations used to estimate glomerular filtarion rate (GFR) are useful to detect "hidden" renal failure (RF) ( coexistence of normal serum creatinine together with GFR < 60 ml/mto/1.73 m2 ). The aim of this study was to analyze the prevalence of this phenomenon in hospitalized patients and how this affects drugs prescription.

Patients and method: 567 patients admitted to the internal medicine section of Barbastro Hospital (Huesca, Spain) during a three months period (april-june 2006) were included. GFR was estimated applying abbreviated MDRD equation. By means of logistic regression analysis we analyzed the factors associated with the presence of "hidden" RF. We also recorded the potentially dangerous drugs prescribed at discharge from hospital.

Results: Prevalence of "Hidden" RF was 10.8 %. NKF chronic kidney disease stages 3.4 or 5 were present in 35.2 % of patients. Variables associated with presence of "hidden" RF were age (expB = 1.035; IC95% 1.012 - 1.060; p = 0.004) and female sex (expB = 4.669; IC95% 2.461 - 8.856; p < 0.0001). Only in 1.8 % of cases GFR was calculated during hospitalisation period. A considerable number of patients with "hidden" RF received treatment with potentially dangerous drugs taking into account his degree of renal failure.

Conclusions: Our results support the introduction of GFR estimation by means of MDRD equation in laboratory reports.