title: The role of clinical pharmacy services in achieving treatment targets in Iranian haemodialysis patients.
abstract: BACKGROUND
  The number of patients suffering from chronic kidney disease (CKD) is increasing worldwide. Hyperphosphataemia and high serum calcium (Ca) and phosphorus (P) product contribute to the substantial increase in cardiovascular events in CKD patients. Although reports of CKD complications in Iranian haemodialysis (HD) patients are comparable to data from other developed countries, management of these complications has failed to meet generally accepted targets. This study evaluated the impact of clinical pharmacy services in the management of complications in HD patients.
  
  
  METHODS
  During a six-month prospective study, clinical pharmacists conducted medical visits in the HD ward and adjusted the patients' medications according to their laboratory findings.
  
  
  RESULTS
  Serum Ca concentration was increased in hypocalcaemia patients and decreased in hypercalcaemia patients until it reached the optimal range in both groups. A decline in serum P level was noted in hyperphosphataemia patients, although it did not reach the target range. The Ca × P product decreased in patients with Ca × P > 55 mg2/dL2. Although it did not reach the goal, there was an increase and decrease in serum intact parathyroid hormone (iPTH) concentration in suboptimal and supraoptimal range patients, respectively. Serum Ca, P and iPTH levels did not change in patients with optimal values at the initiation of the study. Haemoglobin concentration increased in anaemic patients and serum ferritin reached target values in all patients. Total cholesterol, low-density lipoprotein cholesterol and triglycerides decreased to near-optimal values in dyslipidaemia patients.
  
  
  CONCLUSIONS
  This study showed that clinical pharmacy services at the HD centre can improve the management of complications in CKD patients.
authors.affiliation: Faculty of Pharmacy and Nephrology Research Centre, Tehran University of Medical Sciences, PO Box 14155/6451, Tehran 1417614411, Iran. dashtis@sina.tums.ac.ir
authors.forename: Simin
authors.initials: S
authors.lastname: Dashti-Khavidaki
authors.forename: Hossein
authors.initials: H
authors.lastname: Khalili
authors.forename: Sheida
authors.initials: S
authors.lastname: Shahverdi
authors.forename: Mohammad-Reza
authors.initials: MR
authors.lastname: Abbasi
authors.forename: Mahboob
authors.initials: M
authors.lastname: Lessan-Pezeshki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000209:etiology / Q000517:prevention & control*; D001851:Bone Diseases, Metabolic / Q000209:etiology / Q000517:prevention & control*; D050171:Dyslipidemias / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007492:Iran; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010607:Pharmacy Service, Hospital; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D012015:Reference Standards; D006435:Renal Dialysis / Q000009:adverse effects; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000628:therapy*