Abstract

DRUG DOSE-ADJUSTMENT IN CHRONIC KIDNEY DISEASE PATIENTS ADMITTED IN A NEPHROLOGY WARD IN GENERAL HOSPITAL OF NEPAL

Neeti Gupta*, Dr. Nishal Gupta and Dr. Nabin Basnet

ABSTRACT

Drug dose adjustment is a unique problem in management of patients with chronic kidney disease (CKD). CKD significantly affects pharmacokinetics of drugs,[1] so doses have to be adjusted to avoid over dosing and related adverse events or under dosing and poor outcomes of management. Other factors that are affected and suggested to be considered when prescribing to a CKD patient are non-renal clearance, volume of distribution, nephrotoxicity, and protein binding.[2] Doses are adjusted either by dose reduction or lengthening the dose interval. Physicians are aware of the requirement of dose adjustment according to the degree of patient’s renal impairment and have access to guidelines for prescribing to patients with renal impairment,[2] but there are still frequent errors in dose adjustment. These error are shown to be affecting 34%-53%.[3–9] of patients with renal impairment.

Keywords: .