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希腊终末期肾病患者药物不良反应的影响。

Impact of Adverse Drug Reactions in Patients with End Stage Renal Disease in Greece.

机构信息

Department of Nursing, Faculty of Health Sciences, Hellenic Mediterranean University, Estavromenos, GR-71140 Heraklion, Crete, Greece.

Computational BioMedicine Laboratory, Institute of Computer Science, Foundation for Research and Technology-Hellas (FORTH), GR-70013 Heraklion, Crete, Greece.

出版信息

Int J Environ Res Public Health. 2020 Dec 6;17(23):9101. doi: 10.3390/ijerph17239101.

DOI:10.3390/ijerph17239101
PMID:33291233
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7730015/
Abstract

BACKGROUND

Patients with end-stage renal disease (ESRD) require specialized therapeutic interventions. The decreased renal function that modulates the physiology and presence of comorbidities is often associated with variations in the pharmacological response, thus increasing the risk of adverse drug events or reactions (ADE/ADRs) from co-administered drugs.

METHODS

A cross-sectional study to record comorbidities, drug-drug interactions (DDIs), ADE/ADRs in patients with chronic kidney disease of stage five in Greece. The study enrolled 60 patients of mean age 64.8 ± 12.9 years, undergoing hemodialysis three times a week. Demographic and social factors, comorbidities, laboratory test data, medication regimens, DDIs and the reporting of ADE/ADRs were analyzed.

RESULTS

Cardiovascular diseases and diabetes were the main comorbidities. In total, 50 different DDIs of various clinical significance were identified. CNS, GI-track, and musculoskeletal-system-related ADE/ADRs were most often reported by patients. ADE/ADRs as clinical outcome from DDIs were associated in 64% of the total identified DDIs. There was a positive trend between number of medications, ADE/ADRs report and DDIs.

CONCLUSIONS

The impact of ADE/ADRs in ESRD patients should be always considered. Guidelines as well as continuous training in the context of evidence-based clinical practice by healthcare personnel on therapy administration and prevention of adverse events are important.

摘要

背景

终末期肾病（ESRD）患者需要特殊的治疗干预。调节生理机能和存在合并症的肾功能下降通常与药物反应的变化有关，从而增加了合并用药发生不良药物事件或反应（ADE/ADR）的风险。

方法

这是一项在希腊进行的横断面研究，旨在记录患有五期慢性肾脏病患者的合并症、药物-药物相互作用（DDI）和 ADE/ADR。该研究纳入了 60 名平均年龄为 64.8 ± 12.9 岁的每周接受三次血液透析的患者。分析了人口统计学和社会因素、合并症、实验室检查数据、药物治疗方案、DDI 和 ADE/ADR 的报告情况。

结果

心血管疾病和糖尿病是主要的合并症。共发现 50 种不同的具有各种临床意义的 DDI。CNS、GI 道和肌肉骨骼系统相关的 ADE/ADR 是患者最常报告的。在总共确定的 50 种 DDI 中，有 64%的 DDI 与 ADE/ADR 作为临床结果相关。药物数量、ADE/ADR 报告和 DDI 之间存在正相关趋势。

结论

应始终考虑 ESRD 患者的 ADE/ADR 影响。指南以及医疗保健人员在治疗管理和预防不良事件方面基于循证临床实践的持续培训非常重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a35d/7730015/454bb2c56933/ijerph-17-09101-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a35d/7730015/0b5252bc6bc5/ijerph-17-09101-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a35d/7730015/de6dfa6d0b6f/ijerph-17-09101-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a35d/7730015/a1927dbff50e/ijerph-17-09101-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a35d/7730015/fcbfd7f9bb62/ijerph-17-09101-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a35d/7730015/454bb2c56933/ijerph-17-09101-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a35d/7730015/0b5252bc6bc5/ijerph-17-09101-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a35d/7730015/de6dfa6d0b6f/ijerph-17-09101-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a35d/7730015/a1927dbff50e/ijerph-17-09101-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a35d/7730015/fcbfd7f9bb62/ijerph-17-09101-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a35d/7730015/454bb2c56933/ijerph-17-09101-g005.jpg

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