Offurum Ada, Wagner Lee-Ann, Gooden Tanisha
a General Internal Medicine , University of Maryland Medical System Ringgold standard institution , Baltimore , MD , USA.
Expert Opin Drug Saf. 2016 Dec;15(12):1597-1607. doi: 10.1080/14740338.2016.1236909. Epub 2016 Oct 12.
Chronic kidney disease (CKD) confers a higher risk of adverse safety events as a result of many factors including medication dosing errors and use of nephrotoxic drugs, which can cause kidney injury and renal function decline. CKD patients may also have comorbidities such as hypertension and diabetes for which they require more frequent care from different providers, and for which standard, but countervailing treatments, may put them at risk for adverse safety events. Areas covered: In addition to the well-known agents such as iodinated radiocontrast, antimicrobials, diuretics and angiotensin converting enzyme (ACE) inhibitors which can directly affect renal function, safety considerations in the treatment of common CKD complications such as anemia, diabetes, analgesia and thrombosis will also be discussed. Expert opinion: Better outcomes in CKD may be achieved by alerting care providers to the special care needs of kidney patients and encouraging patients to self-manage their disease with the decision support of multidisciplinary patient care teams.
慢性肾脏病（CKD）由于诸多因素，如用药剂量错误和使用肾毒性药物，会导致肾脏损伤和肾功能下降，从而带来更高的不良安全事件风险。CKD患者可能还患有高血压和糖尿病等合并症，为此他们需要不同医疗服务提供者更频繁的护理，而针对这些合并症的标准但相互矛盾的治疗方法，可能会使他们面临不良安全事件的风险。涵盖领域：除了如碘化造影剂、抗菌药物、利尿剂和血管紧张素转换酶（ACE）抑制剂等众所周知的直接影响肾功能的药物外，还将讨论治疗常见CKD并发症（如贫血、糖尿病、镇痛和血栓形成）时的安全注意事项。专家观点：通过提醒医疗服务提供者关注肾病患者的特殊护理需求，并鼓励患者在多学科患者护理团队的决策支持下自我管理疾病，可能会改善CKD的治疗效果。
