title: Drug Dose Adjustment in Dialysis Patients Admitted in Clinics Other Than Internal Medicine.
abstract: Many drugs that are administered during hospitalization are metabolized or excreted through kidneys, consequently require dosage adjustment. We aimed to investigate inappropriate prescription of drugs requiring renal dose adjustment (RDA) in various surgical and medical inpatient clinics. We retrospectively determined dialysis patients hospitalized between January 2007 and December 2010. Inpatient clinics, including cardiology, pulmonary medicine, neurology, infectious diseases (medical clinics) and cardiovascular surgery, orthopedics, general surgery, obstetrics and gynecology, and neurosurgery (surgical clinics), were screened via electronic database. Total and RDA medications were determined. RDA drugs correctly adjusted to creatinine clearance were labeled as RDA-A (appropriate), otherwise as RDA-I (inappropriate). Renal doses of RDA medications were based on the "American College of Physicians Drug Prescribing in Renal Failure, fifth Edition." Two hundred seventeen hospitalization records of 172 dialysis patients (92 men and 80 women) were included in the analysis. Mean age of patients was 59.4 ± 14.6 years, and the mean hospitalization duration was 8.5 ± 7.8 days. In total, 247 (84.3%, percentage in drugs requiring dose adjustment) and 175 (46.2%) drugs have been inadequately dosed in surgical and medical clinics, respectively. The percentage of patients to whom at least 1 RDA-I drug was ordered was 92% and 91.4% for surgical and medical clinics, respectively (P > 0.05). Nephrology consultation numbers were 8 (7.1%) in surgical and 32 (30.4%) in medical clinics. The most common RDA-I drugs were aspirin and famotidine. A significant portion of RDA drugs was ordered inappropriately both in surgical and medical clinics. Nephrology consultation rate was very low. Measures to increase physician awareness are required to improve results.
authors: 1Nephrology Unit, Department of Internal Medicine, Karaman State Hospital, Karaman, Turkey; 2Nephrology Unit, Department of Internal Medicine, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey; 3Extracorporeal Hemocorrection Unit, National Scientific Medical Research Center, Astana, Kazakhstan; 4Department of Cardiology, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey; and 5Department of Internal Medicine, Karaman State Hospital, Karaman, Turkey.
authors: Yalcin
authors: Y
authors: Solak
authors: Zeynep
authors: Z
authors: Biyik
authors: Abduzhappar
authors: A
authors: Gaipov
authors: Mehmet
authors: M
authors: Kayrak
authors: Hilal
authors: H
authors: Ciray
authors: Ahmet
authors: A
authors: Cizmecioglu
authors: Halil Zeki
authors: HZ
authors: Tonbul
authors: Suleyman
authors: S
authors: Turk
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007388:Internal Medicine; D007668:Kidney / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D004364:Pharmaceutical Preparations / Q000008:administration & dosage*; D006435:Renal Dialysis; D012189:Retrospective Studies
chemical_list: D004364:Pharmaceutical Preparations