Measurement of glomerular filtration rate in obese patients: pitfalls and potential consequences on drug therapy.

Details

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State: Public
Version: author
Serval ID
serval:BIB_4F6EB15BC030
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Measurement of glomerular filtration rate in obese patients: pitfalls and potential consequences on drug therapy.
Journal
Obesity Facts
Author(s)
Wuerzner G., Bochud M., Giusti V., Burnier M.
ISSN
1662-4033 (Electronic)
ISSN-L
1662-4025
Publication state
Published
Issued date
2011
Peer-reviewed
Oui
Volume
4
Number
3
Pages
238-243
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
Epidemiological studies have shown that obesity is associated with chronic kidney disease and end stage renal disease. These studies have used creatinine derived equations to estimate glomerular filtration rate (GFR) and have indexed GFR to body surface area (BSA). However, the use of equations using creatinine as a surrogate marker of glomerular filtration and the indexation of GFR for BSA can be questioned in the obese population. First, these equations lack precision when they are compared to gold standard GFR measurements such as inulin clearances; secondly, the indexation of GFR for 1.73 m(2) of BSA leads to a systematic underestimation of GFR compared to absolute GFR in obese patients who have BSA that usually exceed 1.73 m(2). Obesity is also associated with pathophysiological changes that can affect the pharmacokinetics of drugs. The effect of obesity on both renal function and drug pharmacokinetics raises the issue of correct drug dosage in obese individuals. This may be particularly relevant for drugs known to have a narrow therapeutic range or excreted by the kidney.
Keywords
Biological Markers, Body Surface Area, Creatinine/metabolism, Glomerular Filtration Rate/physiology, Humans, Kidney/physiopathology, Kidney Failure, Chronic/drug therapy, Kidney Failure, Chronic/physiopathology, Kidney Function Tests/standards, Obesity/physiopathology, Pharmaceutical Preparations/administration & dosage, Pharmacokinetics, Reproducibility of Results, Research Design
Pubmed
Web of science
Open Access
Yes
Create date
28/06/2011 14:01
Last modification date
20/08/2019 14:05
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