Abstract
We present a convenient reference to predict the appropriate daily dosages (D) of beta-methyldigoxin (BMD) from serum creatinine, serum albumin (Alb), and body weight in elderly patients. In this study, the clinical utility of the reference was compared with that of the previously proposed method to predict D from only estimated creatinine clearance (CLcr). In addition, relative contributions of Alb and CLcr to total glycoside clearance at steady state (CLtot) were assessed to ascertain the indispensability of Alb as the predictor. A total of 61 inpatients aged 70 years and over were prospectively studied. The present method provided a closer correlation between the serum glycoside concentration and the ratio of actual to predicted D (r=0.652) than the previously proposed method (r=0.567). In addition, multiple regression analysis revealed that both of Alb and CLcr contributed to explain the variance in CLtot with similar significance (Alb: F-value=18.64, p=0.0001, CLcr: F-value=16.67, p=0.0001). We consequently concluded that this simple reference is more preferable to the previous method because of its accuracy and convenience in use, and that Alb is necessary for predicting D in the elderly.
