The aim of this study is to identify the degree and direction of fluctuation from one to another renal function group within 2 months after discharge from hospital. In addition, prevalence of adaptations of the prescribed drugs that should result…
ID
Source
Brief title
Condition
- Renal disorders (excl nephropathies)
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
The main study parameter is the estimated glomerular filtration rate (eGFR).
The main endpoint is: 1) What percentage of patients show improved,
deteriorated and unchanged renal function at 14 days after discharge from
hospital compared to the renal function at discharge? Renal function will be
classified according the categories, which are defined in relation to drug
management.
Secondary outcome
Other important endpoints are:
1) What percentage of patients show improved, deteriorated and unchanged renal
function at 2 months after discharge from hospital compared to the renal
function at discharge?
2) Percentage of patients whose actual medications are incorrect according to
the Dutch guidelines in relation to their renal function at 14 days and 2
months after discharge.
3) Percentage of patients in whom fluctuation of the renal function would have
required dose adaptation of a hypothetical selection of drugs at 14 days and 2
months after discharge.
Background summary
Chronic kidney disease (CKD) is associated with a higher mortality rate, as
well as an increased risk of cardiovascular events and morbidity. Impairment of
renal function is common in elderly patients, and their glomerular filtration
rate (GFR) should be taken into account when prescribing renally excreted
drugs. Dose adjustment of or refraining from renally excreted drugs often take
place categorically. In the hospital care setting the renal function may
fluctuate so much that the renal function group and therefore the recommended
dose, may change easily within a few days. The fluctuation of renal function
after discharge from hospital is unknown.
Study objective
The aim of this study is to identify the degree and direction of fluctuation
from one to another renal function group within 2 months after discharge from
hospital. In addition, prevalence of adaptations of the prescribed drugs that
should result from the change in renal function within 2 months after discharge
is determined according to the current Dutch guidelines for the patient*s
actual medication and a hypothetical selection of most frequently prescribed
drugs in elderly patients that require dose adaptation in patients with renal
impairment. Risk factors which might lead to increased risk for incorrectly
prescribed drugs are also identified and analysed.
Study design
A prospective observational study.
Study burden and risks
At discharge, 14 days and 2 months after discharge from hospital a blood sample
will be needed to measure the serum creatinine value. The measurement of
creatinine at discharge is almost always usual care. The additional burden for
the patient consists of two serum creatinine measurements after discharge of
which some are part of usual care. Patients might benefit from participating in
this study because additionally measured renal functions will be reported to
the general practitioner and/or geriatric physician, who then can adapt the
medication of the patient to the renal function reported in an earlier stage
than usual care nowadays.The benefits for healthcare professionals comprise of
confirmation or adjustment of current recommendations for monitoring renal
function after discharge from hospital.
Henri Dunantstraat 1
's-Hertogenbosch 5223GZ
NL
Henri Dunantstraat 1
's-Hertogenbosch 5223GZ
NL
Listed location countries
Age
Inclusion criteria
age >= 70 years,
renal function < 60 ml/min/1.73m2
Exclusion criteria
Patients on dialysis
Patients in their terminal phase
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL41187.028.12 |