Research Article| Volume 13, ISSUE 1, P269-277, March 1993

Assessment of Renal Function in the Old: Special Considerations

  • Robert D. Lindeman
    Address reprint requests to: Robert D. Lindeman, MD, University of New Mexico Hospitals, Department of Medicine, 5th floor ACC, Albuquerque, New Mexico 87131-5271.
    From the Division of Geriatric Medicine, Department of Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico
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      The most important clinical renal function to monitor with age is glomerular filtration rate (GFR), as all other changes in renal function tend to parallel changes in GFR. The serum creatinine and creatinine clearance have become the clinical tests most frequently used to measure GFR. The creatinine clearance decreases at a rate approximately 1% per year after age 40 years. Mean serum creatinine values, however, fail to increase with age because creatinine production, which is dependent on muscle mass, falls at nearly the same rate as the renal clearance of creatinine. Serum creatinine concentrations must be interpreted with this in mind when used to determine or modify dosages of drugs cleared totally, for example, the aminoglycoside antibiotics, or partially, for example, digoxin, by the kidney.
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