Department of Family Medicine, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey.
Ren Fail. 2013 Jul;35(6):906-10. doi: 10.3109/0886022X.2013.801272. Epub 2013 Jun 3.
The main goal of chronic kidney disease (CKD) treatment is the prevention of progression of the disease and complications. Inappropriate drug use in patients with CKD is an important issue, which may cause adverse effects on patients and progression of chronic renal failure. The aim of this study is to find the rate of inappropriate drug use among CKD patients.
The subjects of this study were selected from the patients with a CKD history of minimum one year, who did not receive renal replacement therapy. Patients were asked to provide a digital record of the drugs they used over the last one year. Individually, for each patient, the drugs that may be contraindicative and that require dose adjustment were identified based on glomerular filtration rate (GFR).
This study includes a total of 185 participants - 97 female (52.4%) and 88 male (47.6%) patients. The average age of patients was 60.50 ± 14.56. It was shown that 149 patients (80.5%) were using inappropriate drugs. Seventy (47.0%) were using one, 79 (53.0%) two, 30 (20/1%) three, and 9 (6.4%) four inappropriate drugs. Of CKD patients, 44.3% were aged 65 or over; and in this age group, inappropriate drug use was more frequent compared to the population below 65 (86.6% vs. 75.7%). The drugs used inappropriately were, respectively, nonsteroidal anti-inflammatory drugs (65.8%), quinolone antibiotics (39.0%), ACE inhibitors (26.9%).
Health professionals are required to consider renal functions of all patients, mainly those aged over 65, when administering a treatment.
慢性肾脏病（CKD）治疗的主要目标是预防疾病进展和并发症。CKD 患者用药不当是一个重要问题，可能会对患者造成不良影响，并导致慢性肾功能衰竭的进展。本研究旨在发现 CKD 患者用药不当的发生率。
本研究的研究对象为至少有一年 CKD 病史且未接受肾脏替代治疗的患者。患者被要求提供过去一年使用的药物的数字记录。单独为每位患者确定可能有禁忌症且需要剂量调整的药物，基于肾小球滤过率（GFR）。
本研究共纳入 185 名参与者，其中女性 97 名（52.4%），男性 88 名（47.6%），患者平均年龄为 60.50±14.56 岁。结果表明，149 名患者（80.5%）正在使用不当药物。70 名（47.0%）患者使用一种，79 名（53.0%）患者使用两种，30 名（20/1%）患者使用三种，9 名（6.4%）患者使用四种不当药物。在 CKD 患者中，44.3%的患者年龄在 65 岁或以上；在这个年龄组中，用药不当的比例高于 65 岁以下的人群（86.6%比 75.7%）。使用不当的药物分别是非甾体抗炎药（65.8%）、喹诺酮类抗生素（39.0%）、ACE 抑制剂（26.9%）。
在进行治疗时，卫生专业人员需要考虑所有患者的肾功能，尤其是年龄在 65 岁以上的患者。
