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As people age, so do their kidneys.1 The average decline in renal function is approximately 1 mL/min/year after 30 years old.2 3 Over 40% of people >70 years meet the Kidney Disease Improving Global Outcomes definition of chronic kidney disease (CKD), reflecting the increased prevalence of this condition in older people.4 5 Renal function decline is further accelerated through conditions such as hypertension, atherosclerosis, diabetes and cardiovascular disease, which are common comorbidities in older people.6 Safe prescribing of medication for older people with reduced kidney function is an ongoing challenge. Reduced renal excretion of medications eliminated through the kidney exposes people to increased drug plasma levels and increases the risk of medication-related harm leading to adverse drug events, increased hospitalisations and increased mortality.1 7 The presence of polypharmacy, among other issues, in this age group further increases the likelihood of an older person receiving a medication that is either inappropriate and/or requires dose reduction in the context of their renal insufficiency.5 8