Clinical Pharmacy Programme, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia.
Ann Acad Med Singap. 2009 Dec;38(12):1095-103.
One of the most important drug-related problems in patients with chronic kidney disease (CKD) is medication dosing errors. Many medications and their metabolites are eliminated through the kidney. Thus, adequate renal function is important to avoid toxicity. Patients with renal impairment often have alterations in their pharmacokinetic and pharmacodynamic parameters. The clearance of drugs eliminated primarily by renal filtration is decreased by renal disease. Therefore, special consideration should be taken when these drugs are prescribed to patients with impaired renal function. Despite the importance of dosage adjustment in patients with CKD, such adjustments are sometimes ignored. Physicians and pharmacists can work together to accomplish safe drug prescribing. This task can be complex and require a stepwise approach to ensure effectiveness, minimise further damage and prevent drug nephrotoxicity.
在慢性肾脏病（CKD）患者中，最重要的药物相关问题之一是药物剂量错误。许多药物及其代谢物通过肾脏排泄。因此，充分的肾功能对于避免毒性非常重要。肾功能受损的患者常伴有药代动力学和药效动力学参数的改变。主要通过肾滤过消除的药物清除率因肾脏病而降低。因此，在为肾功能受损的患者开具这些药物时应特别注意。尽管在 CKD 患者中进行剂量调整非常重要，但有时会忽略这些调整。医生和药剂师可以共同努力，实现安全的药物处方。这项任务可能很复杂，需要逐步进行，以确保有效性、最小化进一步损害并防止药物肾毒性。
