• J Simon Bell, Natalie Blacker, V Tammy Leblanc, Christopher P Alderman, Adam Phillips, Debra Rowett, Simone Rossi, Oliver Frank, and Alan Husband.
• Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia.
• Aust Fam Physician. 2013 Jan 1; 42 (1-2): 24-8.

BackgroundRenal function is an important prescribing consideration. On average, glomerular filtration rate declines by about 10 mL/min every 10 years after the age of 40. Renal impairment may cause medicines to accumulate or cause toxicity, especially if the medicine has a narrow therapeutic index.ObjectiveTo present an overview of prescribing considerations in the primary care setting for patients with chronic renal impairment.DiscussionSerum creatinine considered in isolation is not a reliable indicator of renal function. The estimated glomerular filtration rate provided in pathology reporting can alert prescribers to possible renal impairment and the need to consider dose adjustments. The Cockcroft-Gault equation should be used to adjust medicine doses. Renal function monitoring is recommended for patients using medicines that can impair renal function or cause nephrotoxicity (eg. NSAIDs, ACEIs, ARBs).

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