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Related Experiment Videos

Drug prescribing for patients with changing renal function.

T G Cantú1, E F Ellerbeck, S W Yun

  • 1Department of Pharmacy, Johns Hopkins Hospital (JHH), Baltimore, MD 21287.

American Journal of Hospital Pharmacy
|December 1, 1992
PubMed
Summary

Renal dysfunction affects 5% of hospitalized patients, particularly the elderly. Many patients with renal impairment receive excessive drug dosages, highlighting the need for better physician alerts.

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Area of Science:

  • Nephrology
  • Clinical Pharmacy
  • Geriatrics

Background:

  • Renal dysfunction is common in hospitalized patients.
  • Older adults are disproportionately affected by impaired kidney function.
  • Prescribing practices for renally eliminated drugs require careful consideration in this population.

Purpose of the Study:

  • To determine the prevalence and course of renal dysfunction in hospitalized patients.
  • To assess the appropriateness of prescribing renally eliminated drugs for patients with renal compromise.
  • To identify potential risks associated with drug dosing in renally impaired inpatients.

Main Methods:

  • Screening of adult inpatients for renal dysfunction (estimated creatinine clearance < 40 mL/min).
  • Monitoring of renal function changes in compromised patients.

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  • Comparison of prescribed renally eliminated drug regimens with manufacturer recommendations.

    • Main Results:

    • 195 (5%) of 3800 screened patients had renal dysfunction, mostly over 65 years old.
    • 45% of renally compromised patients receiving renally eliminated drugs were given dosages exceeding recommendations.
    • Elderly patients showed a lower likelihood of renal function improvement.

    Conclusions:

    • Hospitalized patients, especially the elderly, frequently experience renal dysfunction.
    • A significant proportion of renally impaired patients receive potentially excessive drug dosages.
    • Physician alert systems for renally eliminated drugs must account for dynamic changes in renal function.