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| Natura: | Artículo científico |
| Lingua: | en |
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Centro de investigaciones y Publicaciones Farmacéuticas
2019
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| Accesso online: | https://www.redalyc.org/articulo.oa?id=69060019002 https://www.redalyc.org/journal/690/69060019002/ https://www.redalyc.org/journal/690/69060019002/html/ https://www.redalyc.org/journal/690/69060019002/69060019002.epub https://www.redalyc.org/journal/690/69060019002/movil |
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| _version_ | 1866815645740433408 |
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| author | Rayane Saad |
| author_facet | Rayane Saad |
| contents | Evaluation of renal drug dosing adjustment in chronic kidney disease patients at two university hospitals in Lebanon Rayane Saad Souheil Hallit Bahia Chahine Medicina Lebanon Physicians Drug Overdose Medication Errors Renal Insufficiency Background: Inappropriate medication dosing in patients with chronic kidney disease can cause toxicity or ineffective therapy. Patients are at a high risk of developing related adverse events caused by the altered effect of drugs in conjunction with the use of polypharmacy to treat comorbid conditions. This necessitates adequate renal dosing adjustments.Objective: The current study aims at assessing whether appropriate dosing adjustments were made in hospitalized patients with chronic kidney disease.Methods: A retrospective descriptive study was conducted at two university hospitals in Beirut between January and December 2016. All adult CKD patients with creatinine clearance less than 60 ml/min and receiving at least one medication that require renal dosing adjustment were included. Kidney function was estimated from serum creatinine using Cockcroft-Gault equation, and dose appropriateness was determined by comparing practice with specific guidelines. The rates of renal drug dosing adjustment were investigated, in addition to the influence of possible determinants, such as the severity of renal impairment, reason of hospital admission, and other patient characteristics.Results: 2138 patients admitted in 2016 were screened. 223 adults receiving 578 drug orders that require adjustment were included. Among the 578 orders, 215 (37%) were adjusted adequately, 284 (49%) were adjusted inadequately, and 79 (14%) were not adjusted at all. Beta-blockers were the most inadequately dosed (83.6%) class of medication, whereas lipid-lowering agents had the highest percentage of adequate dosing (65.1%). As per patient, 84.3% of patients appeared to be receiving at least one inappropriate drug dose.Conclusions: Our study confirms that physicians are not prescribing appropriate dosing adjustments in chronic kidney disease inpatients, which may have deleterious effects. This highlights the need for more nephrology consultation and the implementation of physician education programs. 2019 artículo científico 1885-642X https://www.redalyc.org/articulo.oa?id=69060019002 https://www.redalyc.org/journal/690/69060019002/ https://www.redalyc.org/journal/690/69060019002/html/ https://www.redalyc.org/journal/690/69060019002/69060019002.epub https://www.redalyc.org/journal/690/69060019002/movil 10.18549/PharmPract.2019.1.1304 en http://www.redalyc.org/revista.oa?id=690 Pharmacy Practice application/pdf Centro de investigaciones y Publicaciones Farmacéuticas Pharmacy Practice (España) Num.1 Vol.17 |
| format | Artículo científico |
| id | redalyc_69060019002 |
| language | en |
| publishDate | 2019 |
| publisher | Centro de investigaciones y Publicaciones Farmacéuticas |
| spellingShingle | Evaluation of renal drug dosing adjustment in chronic kidney disease patients at two university hospitals in Lebanon Rayane Saad Medicina Lebanon Physicians Drug Overdose Medication Errors Renal Insufficiency Evaluation of renal drug dosing adjustment in chronic kidney disease patients at two university hospitals in Lebanon Rayane Saad Souheil Hallit Bahia Chahine Medicina Lebanon Physicians Drug Overdose Medication Errors Renal Insufficiency Background: Inappropriate medication dosing in patients with chronic kidney disease can cause toxicity or ineffective therapy. Patients are at a high risk of developing related adverse events caused by the altered effect of drugs in conjunction with the use of polypharmacy to treat comorbid conditions. This necessitates adequate renal dosing adjustments.Objective: The current study aims at assessing whether appropriate dosing adjustments were made in hospitalized patients with chronic kidney disease.Methods: A retrospective descriptive study was conducted at two university hospitals in Beirut between January and December 2016. All adult CKD patients with creatinine clearance less than 60 ml/min and receiving at least one medication that require renal dosing adjustment were included. Kidney function was estimated from serum creatinine using Cockcroft-Gault equation, and dose appropriateness was determined by comparing practice with specific guidelines. The rates of renal drug dosing adjustment were investigated, in addition to the influence of possible determinants, such as the severity of renal impairment, reason of hospital admission, and other patient characteristics.Results: 2138 patients admitted in 2016 were screened. 223 adults receiving 578 drug orders that require adjustment were included. Among the 578 orders, 215 (37%) were adjusted adequately, 284 (49%) were adjusted inadequately, and 79 (14%) were not adjusted at all. Beta-blockers were the most inadequately dosed (83.6%) class of medication, whereas lipid-lowering agents had the highest percentage of adequate dosing (65.1%). As per patient, 84.3% of patients appeared to be receiving at least one inappropriate drug dose.Conclusions: Our study confirms that physicians are not prescribing appropriate dosing adjustments in chronic kidney disease inpatients, which may have deleterious effects. This highlights the need for more nephrology consultation and the implementation of physician education programs. 2019 artículo científico 1885-642X https://www.redalyc.org/articulo.oa?id=69060019002 https://www.redalyc.org/journal/690/69060019002/ https://www.redalyc.org/journal/690/69060019002/html/ https://www.redalyc.org/journal/690/69060019002/69060019002.epub https://www.redalyc.org/journal/690/69060019002/movil 10.18549/PharmPract.2019.1.1304 en http://www.redalyc.org/revista.oa?id=690 Pharmacy Practice application/pdf Centro de investigaciones y Publicaciones Farmacéuticas Pharmacy Practice (España) Num.1 Vol.17 |
| title | Evaluation of renal drug dosing adjustment in chronic kidney disease patients at two university hospitals in Lebanon |
| topic | Medicina Lebanon Physicians Drug Overdose Medication Errors Renal Insufficiency |
| url | https://www.redalyc.org/articulo.oa?id=69060019002 https://www.redalyc.org/journal/690/69060019002/ https://www.redalyc.org/journal/690/69060019002/html/ https://www.redalyc.org/journal/690/69060019002/69060019002.epub https://www.redalyc.org/journal/690/69060019002/movil |