Escribá-Martí Gema, Cámara-Ramos Iker, Climent-Catalá Maria Teresa, Escudero-Quesada Verónica, Salar-Ibáñez Luis
Farmacéutica comunitaria en Segart (Valencia). España.
Farmacéutico comunitario en Bilbao. España.
Farm Comunitarios. 2023 Oct 10;15(4):37-44. doi: 10.33620/FC.2173-9218.(2023).29. eCollection 2023 Oct 16.
Chronic kidney disease is a prevalent problem without specific treatment. Early detection is important and estimated glomerular filtration rate (eGFR) is a very affordable test that can be performed in community pharmacies. If present, it is very important not to further damage the kidney by avoiding the use of nephrotoxic drugs and adjusting the doses of other renal elimination drugs and the community pharmacy is very well positioned to do this.
To describe the methodology used to detect nephrotoxic drugs and adjust doses of other drugs in community pharmacies for subsequent referral to primary care.
Multicentre experimental multicentre uncontrolled follow-up study carried out in community pharmacies in 4 autonomous communities in Spain. Patients who met the inclusion criteria and signed the informed consent form were included. Those with eGFR <60 ml/min/1.73m were studied and their medication was analysed using the BOT Plus and 4 other sources of information.
670 patients were included, 215 of them with eGFR<60ml/min/1.73m. Of these 90 (41.9%) needed some type of adjustment in the pharmacist's judgement. Of these 90, 43.3% (39) had some kind of change after the pharmacist's intervention.
In patients with low glomerular filtration rate, with the appropriate methodology, the community pharmacist is able to detect the use of nephrotoxic drugs or the use of drugs at doses higher than those recommended according to their renal status.
慢性肾脏病是一个普遍存在的问题，且尚无特效治疗方法。早期检测很重要，而估算肾小球滤过率（eGFR）是一项成本低廉的检测项目，可在社区药房进行。如果存在慢性肾脏病，避免使用肾毒性药物以及调整其他经肾脏排泄药物的剂量以防止进一步损害肾脏非常重要，而社区药房在这方面具有很好的条件。
描述在社区药房检测肾毒性药物并调整其他药物剂量以便随后转诊至初级保健机构所使用的方法。
在西班牙4个自治区的社区药房开展多中心实验性多中心非对照随访研究。纳入符合纳入标准并签署知情同意书的患者。对估算肾小球滤过率<60 ml/（min·1.73m²）的患者进行研究，并使用BOT Plus及其他4种信息来源分析其用药情况。
共纳入670例患者，其中215例估算肾小球滤过率<60ml/（min·1.73m²）。在药剂师判断下，这些患者中有90例（41.9%）需要某种类型的调整。在这90例患者中，43.3%（39例）在药剂师干预后有某种变化。
对于肾小球滤过率低的患者，采用适当的方法，社区药剂师能够检测出肾毒性药物的使用情况或药物使用剂量高于根据其肾脏状况所推荐的剂量的情况。
