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Medication Safety Principles and Practice in CKD.

Chanel F Whittaker¹, Margaret A Miklich², Roshni S Patel³

¹Department of Pharmacy Practice and Science, University of Maryland School of Pharmacy, Baltimore, Maryland.

Clinical Journal of the American Society of Nephrology : CJASN

|June 20, 2018

Summary

This summary is machine-generated.

Patients with kidney disease face medication safety risks due to reduced kidney function and multiple health conditions. This review highlights essential drug information for safe medication use in chronic kidney disease (CKD).

Keywords:

Iatrogenic Disease Kidney Failure, Chronic Medical Errors Multimorbidity Patient Safety Pharmaceutical Preparations Renal Insufficiency, Chronic chronic kidney disease deprescribing diabetes mellitus heart failure hypertension medication safety renal drug dosing

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Area of Science:

Nephrology
Clinical Pharmacy
Patient Safety

Background:

Iatrogenic injury is a major concern in medical care, with medications being a significant source of errors.
Kidney disease presents unique challenges to safe medication administration due to impaired drug elimination and multimorbidity.
Patients with chronic kidney disease (CKD) are vulnerable to medication-induced kidney injury and metabolic disturbances.

Purpose of the Study:

To identify key issues and threats to safe medication use in patients with predialysis CKD.
To provide guidance on drug avoidance, dose modification, and potential complications in CKD patients.
To emphasize the importance of cautious medication management in kidney disease.

Main Methods:

Review of existing literature and clinical guidelines on medication safety in kidney disease.
Focus on predialysis CKD, excluding end-stage kidney disease (ESKD) and transplantation.
Analysis of drugs requiring avoidance or dose adjustment and common medication complications.

Main Results:

Reduced kidney function affects the elimination of nearly half of all medications.
Multimorbidity in kidney patients, often involving diabetes and hypertension, complicates medication management.
Medications can exacerbate existing kidney disease and cause metabolic derangements.

Conclusions:

Safe medication use in CKD requires careful consideration of drug properties and patient-specific factors.
Awareness of drugs to avoid or adjust is crucial for preventing adverse events.
This review offers essential insights for healthcare providers managing medications in predialysis CKD patients.