An investigation of the association between prolonged sedation and renal function in patients with delirium who received risperidone

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  • リスペリドン投与中のせん妄患者における鎮静の遷延と腎機能との関連についての検討

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<p>Risperidone is an antipsychotic agent frequently used for the treatment of delirium. It has been reported that the clearance of risperidone and the active moiety (risperidone plus 9-hydroxy-risperidone) was reduced in renal disease patients, and thus renal impairment can result in prolonged sedation in patients with delirium during the administration of risperidone. Such prolonged sedation may result in adverse events including aspiration pneumonia and falls. The purpose of this retrospective study was to investigate the association between the prolonged sedation and renal function in inpatients with delirium who were administered risperidone at the Kurashiki Central Hospital from January 2013 to October 2014. The renal function of patients was evaluated by serum creatinine (Cr), estimated glomerular filtration rate (eGFR) and estimated creatinine clearance by Cockcroft-Gault formula (CCr). Among 84 patients who received risperidone, prolonged sedation did not occur in 69 patients. From 68 patients with a normal Cr level, 60 did not experience prolonged sedation under risperidone administration (sensitivity 87.0%, specificity 46.7%). From 53 patients with a eGFR ≧60ml/min/1.73m2 and CCr ≧50ml/min, 48 did not experience prolonged sedation (sensitivity 69.6%, specificity 66.7%). From 17 patients with a eGFR ≧90ml/min/1.73m2 and CCr ≧80ml/min, there were no patients who experienced prolonged sedation (sensitivity 24.6%, specificity 100%). The result of this study suggests that patients with high risk of prolonged sedation under risperidone might be identified according to Cr, eGFR and CCr values.</p>

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