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Rachel W. Flurie and Gary R. Matzke

Chronic kidney disease (CKD) is a prevalent disease in the United States that disproportionately affects the elderly. The national prevalence is approximately 15 percent and reaches nearly 50 percent in adults aged 70 years and older (1). CKD stages 1 and 2 are characterized by a GFR >60 mL/min/1.73 m2, and dose adjustments are usually indicated only for drugs that have a narrow therapeutic index, such as aminoglycosides and vancomycin. CKD stages 3, 4, and 5 are characterized by progressively lower GFR—30 to 59, 15 to 29, and <15 mL/min/1.73m2, respectively—and drug dose adjustment