Abstract

DRUG DOSAGE ADJUSTMENT IN PATIENTS WITH CHRONIC KIDNEY DISEASE AT NATIONAL KIDNEY CENTER

Pawan Khatri*, Nabin Pathak, Thakur Pokharel, Sujana Shakya and Dr. Balmukunda Regmi

ABSTRACT

Background: Inappropriate Drug dosing and the risk of toxicities are common with Chronic Kidney disease patients. Therefore, appropriate dosing is obligatory to prevent the drug toxicities. The present study was performed to investigate the appropriateness of dose adjustment of the drugs that are toxic to kidney. Methods: A prospective study was performed at the National Kidney Center, Kathmandu in the Chronic Kidney Disease patients. All patients with renal clearance ≤60 ml/min/1.73 m2 were included for the analysis. Data with respect to patient’s clinical, medications and their dosages, laboratory findings were extracted from medical record. Results: There was a total of 1513 prescribed drugs in 196 impaired renal function patients. The drugs excreted by the kidney or having nephrotoxic effect were 329. Dose adjustment according to renal function was judged as necessary in 180 medications and 149 were to be used with caution. Among these, 143 (79% of 180) medications were considered appropriate in dosing, whereas 37 (21%) were inappropriate. Conclusions: In few drugs inappropriate doses was seen among Chronic Kidney Disease patients. Raising proper awareness and monitoring system for inappropriate dosing is critical to improve the quality of care in patients.

Keywords: chronic Kidney disease, dose adjustment, renal drug.