Abstract

A PROSPECTIVE OBSERVATIONAL STUDY ON MEDICATIONS PRESCRIBED AND DOSAGE ADJUSTMENT IN PATIENTS WITH RENAL IMPAIRMENT AT A TERTIARY CARE TEACHING HOSPITAL

Jazeeba Maheen*, Ayesha Siddiqui, Hajra Fatima, Maseera Fatima, Sajid Miyan

ABSTRACT

Background: In individuals with renal impairment, the wrong medicine dosage might result in toxicity or ineffective treatment. Patients are at a significant risk of experiencing associated adverse events due to drug interactions when polypharmacy is utilized to treat comorbid diseases. This calls for suitable changes to the renal dosage. Aim & Objectives: This study aims to study prescription patterns and dosage adjustments for medications in patients with renal impairment. Materials & Methods: It is a prospective and observational study done over a period of six months in Osmania general hospital at a tertiary care teaching hospital, study included patients of either sex, patients above 18 years, patients diagnosed with renal impairment, patients with confirmed diagnosis of AKI and CKD. Whereas pregnant and lactating mothers, patient with a gap in their medical history, cancer and covid patients and patients with other disease, and patient is regarded to be morbid are excluded from the study. Results: In our study of 110 patients, most patients were Male (60%) & Female (40%). With age between 50-59 were found to be more effected. The most common risk factor and comorbidities was found to be hypertension (74%) diabetes mellitus (51%), a large number of patients are suffering from stage 5 of ckd (52%), stage 4 ckd (31%) followed by other stages which is classified by KDOQI classification. Based on the rifle criteria classification (54.54%) patients comes in the category of failure followed by, (20.90%) patients fall in the category of ESRD. Majority of patients serum creatinine was found to be in between 4.1-6.0mg/dl. There was significant decrease in EGFR was noted and majority were found to be in between 0-10% of EGFR. According to Cockcroft gault formula for estimating creatinine clearance (25.45%) patients were adjusted for the dose and not adjusted was (0.90%) and others doesn’t require dosage adjustment. The prescribing patterns of drugs were antihypertensives, antidiabetic, diuretics, antibiotics, proton pump inhibitor, anemic drugs, antacids, antiplatelets etc. The most prescribed drug was loop diuretic. Conclusion: This study examines prescription patterns and dosage adjustments for medications in patients with renal impairment, and drug interactions in prescription and focusing on those aged 18 and above. The findings highlight the significance of individualized treatment approaches in optimizing therapeutic success while minimizing potential hazards. More study and collaboration among healthcare experts could result in better medication management guidelines for patients with renal impairment.

Keywords: KEYWORDS: Creatinine clearance, Chronic kidney disease, Dose adjustment, Kidney failure, Renal impairment.