CP-057 Dosage adjustment of epoetin β and darbepoetin α in chronic kidney disease

ABSTRACTBackgroundIn patients with renal impairment, inappropriate medication dosing can develop adverse drug reactions (ADRs) or ineffective therapy due to declined renal function. This necessitates proper renal dosing adjustment. Using a retrospective analysis of medical records, this study was proposed to evaluate medication dosage adjustment in hospitalized chronic kidney disease (CKD) patients.MethodsThis retrospective review of medical records was conducted at the Institute of Kidney Disease (IKD), Peshawar. It included all CKD patients hospitalized between June 01, 2019 and May 31, 2020 and receiving at least one medication that needed adjustment. Glomerular filtration rate was calculated using Renal Disease Diet Modification (RDDM) equation, and dose suitability was established by evaluating practice with relevant guidelines.ResultsOf the total 1537 CKD patients, 231(15.03%) had evidence of dosing error, which were considered for final analysis. Overall, 1549 drugs were prescribed, 480(30.99%) drugs required dose adjustment of which 196(40.42%) were adjusted properly and the remaining 286(59.58%) were unadjusted. The most common unadjusted drugs were meropenem, cefepime, ciprofloxacin and rosuvastatin, whereas captopril, aspirin, bisoprolol, pregabalin and levofloxacin had the highest percentage of adjusted drugs. On multivariate logistic regression, the number of drugs requiring dosing adjustments and obstructive nephropathy were found to be statistically significant factors that increased the likelihood of the medication dosing errors: A unit increase in the number of drugs requiring dose adjustment increases 5.241 times the likelihood of dosing error. Similarly the presence of obstructive nephropathy (Odds ratio (OR) 0.383, 95% confidence interval (Cl) [0.153-0.960] P= 0.041) was found to be significantly associated with dosing error after adjustment for potential confounding factors.ConclusionThe dosing of more than half of the prescribed drugs that required adjustment in CKD were not adjusted which showed that medication dosing errors were high. This highlights the importance of medication prescription according to guidelines in CKD patients to improve the outcomes of pharmacotherapy and patients’ quality of life.

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Pharmacists’ attitude, self‐reported knowledge and practice of dosage adjustment among chronic kidney disease patients in Malaysia

Journal of Pharmacy Practice and Research ◽

10.1002/jppr.1450 ◽

2019 ◽

Vol 49 (2) ◽

pp. 179-185

Author(s):

Xin R. Teh ◽

Shaun W. H. Lee

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Dosage Adjustment ◽

Knowledge And Practice

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CP-052 Chronic kidney disease: Dosage adjustment of epoetin β and darbepoetin α

European Journal of Hospital Pharmacy ◽

10.1136/ejhpharm-2016-000875.52 ◽

2016 ◽

Vol 23 (Suppl 1) ◽

pp. A23.1-A23

Author(s):

C Pérez-Diez ◽

H Navarro ◽

N De la Llama ◽

J Pérez-Pérez ◽

M Abad-Sazatornil

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Dosage Adjustment

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Drug Dosage Adjustment of Chronic Kidney disease Patients at Nephrology Ward in Tertiary Care Hospital of Nepal

Europasian Journal of Medical Sciences ◽

10.46405/ejms.v2i1.39 ◽

2020 ◽

Vol 2 (1) ◽

pp. 41-50

Author(s):

Sonu Pakhrin ◽

Sumitra Shrestha ◽

Renu Karki ◽

Nirmal Raj Marasine ◽

Rajendra Lama ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Dose Adjustment ◽

Dosage Adjustment ◽

Tertiary Care ◽

College Teaching ◽

Drug Dosage ◽

Care Hospital ◽

Laboratory Findings ◽

Drug Dosage Adjustment

Background: Drug dosage adjustment is essential for chronic kidney disease patients (CKD) patients. If it is not done properly, this will lead to an increase in toxicity and a decrease in the effectiveness of therapy. The objective of the present study was to assess whether appropriate dosage adjustments were made in hospitalized CKD patients. Methods: A descriptive cross-sectional study was carried out among 80 CKD patients with stage II to V admitted in the nephrology ward of Chitwan Medical College Teaching Hospital, Nepal between 1st August to 30th November 2018. All patients with renal clearance ≤90 ml/min/1.73 m2 were included for the analysis. Data concerning patient’s clinical, medications and dosages, laboratory findings were extracted from the medical record section. Results: Total of 81 numbers of prescribed drugs was found in eighty hospitalized CKD patients. Twenty-seven were found requiring dose adjustment. Dose adjustment according to renal function was judged as necessary in 27 dose adjustment required drugs. Among these, 11 (40.7% of 27) drugs were considered appropriate in dosing, whereas 16 (59.3%) were found to be inappropriate. A total of 13 (81.3%) number of drugs were inappropriately adjusted in stage V patients. Conclusion: Dosing errors were the most frequently observed challenge in the patient hospitalized with CKD. This study also intensified the need for strong monitoring of drug therapy which will bear in achieving the better therapeutic outcomes that improve the quality of life and decrease the various problems associated with dosing error.

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