A survey of measurement situation of renal function with outpatients and CKD stage 3-5 patients’ prescriptions for renally eliminated drugs in Ehime University Hospital.

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  • 愛媛大学医学部附属病院における外来患者での腎機能測定実態とCKD ステージ3-5 の患者に対する腎排泄型薬剤の処方実態
  • エヒメ ダイガク イガクブ フゾク ビョウイン ニ オケル ガイライ カンジャ デ ノ ジンキノウ ソクテイ ジッタイ ト CKD ステージ 3-5 ノ カンジャ ニ タイスル ジンハイセツガタ ヤクザイ ノ ショホウ ジッタイ

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Abstract

<p>The number of patients with chronic kidney disease (CKD) has been continuously increasing in Japan. Therefore, proper use of renally eliminated drugs and potential nephrotoxic drugs has become more important. In Ehime University Hospital, pharmaãsts visit inpatients after their admission and check any drugs brought to hospital, and prevent over-dose administrating renally eliminated drugs in CKD patients. However, pharmacists cannot become involved with outpatients. There are concerns that outpatients may be at increased risk of over-dose administration of renally eliminated drugs. Therefore, in this study, we examined the prescription of renally eliminated drugs for outpatients. The subjects were 2969 outpatients prescribed renally eliminated drugs during July 2012. In 792 of the outpatients, serum creatinine levels and estimated glomerular filtration rate (eGFR) were measured. These 792 patients were classified by stage of CKD based on their eGFR. The eGFR was calculated as: 194 ✕ Cr-1.094 ✕ age-0.287 ✕ (female:0.739). Patients and dosages were retrospectively investigated. There were 295 patients with CKD stages 3 to 5 (37.2%), many of whom were prescribed renally eliminated drugs, such as silodosin, allopurinol, levofloxaãn, and famotidine. In 6 patients prescribed silodosin (40%), 7 patients prescribed allopurinol (9%), 5 patients prescribed levofloxaãn (8%), and 17 patients prescribed famotidine (7%), the drug had been overdose administration based on their renal function. In this study, we determined the use of renally eliminated drugs for outpatients. Our results indicate that CKD outpatients may have an increased risk of over-dose administration of renally eliminated drugs. Hospital pharmaãsts are working closely with health insurance pharmaães to prevent overdose administration of renally eliminated drugs for outpatients with CKD.</p>

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