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首页> 外文期刊>The journals of gerontology.Series A. Biological sciences and medical sciences >Concealed renal failure and adverse drug reactions in older patients with type 2 diabetes mellitus.
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Concealed renal failure and adverse drug reactions in older patients with type 2 diabetes mellitus.

机译：老年2型糖尿病患者的隐匿性肾衰竭和药物不良反应。

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BACKGROUND: In elderly patients serum creatinine may be normal despite decreased glomerular filtration rate (GFR). The aim of this study was to evaluate the prevalence of this "concealed" renal failure, i.e., renal failure with normal serum creatinine levels, in elderly diabetic patients, and to verify whether it is a risk factor for adverse drug reactions (ADR) to hydrosoluble drugs. METHODS: We used data on 2257 hospitalized patients with type 2 diabetes mellitus enrolled in the Gruppo Italiano di Farmacovigilanza nell'Anziano study. On the basis of serum creatinine and calculated GFR, patients were grouped as follows: normal renal function (normal serum creatinine levels and normal GFR), concealed (normal serum creatinine levels and reduced GFR), or overt (increased creatinine levels and reduced GFR) renal failure. GFR was calculated using the Modification of Diet in Renal Disease (MDRD) equation. The outcome of the study was the incidence of ADR to hydrosoluble drugs during the hospital stay. The relationship between renal function and ADR was evaluated using Cox regression analysis including potential confounders. RESULTS: Concealed renal failure was observed in 363 (16.1%) of patients studied. Patients with concealed or overt renal failure were older, had more frequently cognitive impairment and polypharmacy, and had lower serum albumin levels than did those with normal renal function. Both concealed (hazard ratio = 1.90; 95% confidence interval, 1.04-3.48; p =.036) and overt (hazard ratio 2.23; 95% confidence interval, 1.40-3.55; p significantly associated with ADR to hydrosoluble drugs. The use of more than four drugs also qualified as an independent risk factor for ADRs to hydrosoluble drugs during hospital stay. CONCLUSIONS: Older diabetic patients should be systematically screened to ascertain the presence of concealed renal failure in an attempt to optimize the pharmacological treatment and reduce the risk of ADRs.
机译：背景：尽管肾小球滤过率（GFR）降低，但老年患者的血清肌酐仍可能正常。这项研究的目的是评估老年糖尿病患者中这种“隐匿性”肾功能衰竭的患病率，即血清肌酐水平正常的肾功能衰竭，并验证它是否是导致药物不良反应（ADR）的危险因素。水溶性药物。方法：我们使用了Gruppo Italiano di Farmacovigilanza nell'Anziano研究中2257例住院的2型糖尿病患者的数据。根据血清肌酐和计算的GFR，将患者分组为：正常肾功能（正常血清肌酐水平和正常GFR），隐蔽（正常血清肌酐水平和GFR降低）或明显（升高的肌酐水平和GFR降低）肾衰竭。 GFR使用肾脏疾病饮食调整（MDRD）公式计算。该研究的结果是住院期间ADR对水溶性药物的发生率。使用Cox回归分析（包括潜在的混杂因素）评估肾功能与ADR之间的关系。结果：在研究的363名患者中观察到隐匿性肾衰竭。隐性或明显肾功能衰竭的患者年龄较大，认知障碍和多药治疗的频率更高，且血清白蛋白水平低于肾功能正常的患者。隐蔽（危险比= 1.90; 95％置信区间，1.04-3.48; p = .036）和显性（危险比2.23; 95％置信区间，1.40-3.55; p与水溶性药物的ADR均显着相关。结论：在住院期间，有四种以上的药物也可以作为ADRs成为水溶性药物的独立危险因素结论：应该对老年糖尿病患者进行系统筛查，以确定是否存在隐匿性肾衰竭，以优化药物治疗并降低患ADR的风险。 ADR。

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