Drug Dosage Adjustments According to Renal Function at Hospital Discharge

Background: Adequate dosing of medication in renal impairment to prevent hospitalizations and adverse reactions is a growing concern in the aging society. There are several dosing guidelines available, but structural use is uncommon. Objective: To perform a retrospective analysis of the incidence of...

Full description

Saved in:
Bibliographic Details
Published in:The Annals of pharmacotherapy 2006-07, Vol.40 (7), p.1254-1260
Main Authors: van Dijk, Elisabeth A, Drabbe, Nathalie RG, Kruijtbosch, Martine, De Smet, Peter AGM
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Case-Control Studies
Creatinine - metabolism
Drug Monitoring
Female
Hospitalization
Humans
Kidney Diseases - drug therapy
Kidney Diseases - physiopathology
Male
Medical sciences
Middle Aged
Nephrology. Urinary tract diseases
Nephropathies. Renovascular diseases. Renal failure
Patient Discharge - statistics & numerical data
Pharmaceutical Preparations - administration & dosage
Pharmacology. Drug treatments
Renal failure
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background: Adequate dosing of medication in renal impairment to prevent hospitalizations and adverse reactions is a growing concern in the aging society. There are several dosing guidelines available, but structural use is uncommon. Objective: To perform a retrospective analysis of the incidence of required versus implemented dosage adjustments according to guidelines in patients with renal insufficiency at discharge and evaluate specific determinants responsible for the percentage of overlooked dosage adjustments. Methods: Medication and laboratory data were collected from patients at discharge during February and November 2004. For patients with a calculated creatinine clearance less than 51 mL/min/1.73 m2, the necessity for dosage adjustments was evaluated by pharmacists. All data were collected for further research and subsequent statistical analysis. Results: At discharge, 237 of 647 (36.6%) patients had a calculated creatinine clearance less than 51 mL/min/1.73 m2. Dosage adjustment based on renal function was necessary in 411 of 1718 (23.9%) of prescriptions. These adjustments were performed in 242 (58.9%) prescriptions and not performed in 169 (41.1%) cases. The risk of not adjusting the dosage was significantly associated with serum creatinine levels greater than 1.71 mg/dL and creatinine clearance less than 35 mL/min/1.73 m2 (p
ISSN:1060-0280
1542-6270
DOI:10.1345/aph.1G742