Hospitalized patients require the use of a variety of drugs, many of which\nindividually or in combination have the potential to cause kidney damage. The use of\npotentially nephrotoxic drugs is often unavoidable, and the need for dose adjustment\nshould be evaluated. This study is aimed at assessing concordance in information on\ndrug-induced nephrotoxicity and dose adjustment recommendations by comparing four\ndrug information sources (DRUGDEXÃ?®, UpToDateÃ?®, MedscapeÃ?® and the Brazilian\nTherapeutic Formulary) using the formulary of a Brazilian public hospital. A total of\n218 drugs were investigated. The global Fleissââ?¬â?¢ kappa coefficient was 0.265 for\nnephrotoxicity (p < 0.001; CI 95%, 0.211ââ?¬â??0.319) and 0.346 for recommendations\n(p < 0.001; CI 95%, 0.292ââ?¬â??0.401), indicating fair concordance among the sources.\nAnti-infectives and anti-hypertensives were the main drugs cited as nephrotoxic by the different sources. There were no clear definitions for qualitative data or quantitative values\nfor dose adjustments among the four information sources. There was no advice for dosing\nfor a large number of the drugs in the international databases. The National Therapeutic\nFormulary offered imprecise dose adjustment recommendations for many nephrotoxic\ndrugs. Discrepancies among information sources may have a clinical impact on patient care\nand contribute to drug-related morbidity and mortality.
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