Chronic kidney diseases a worldwide public health problem with an increasing incidence, prevalence, poor outcomes and high cost. Inappropriate use of drugs in patients with renal impairment (RI) may therefore be harmful and have deleterious effects. The aim of this study to know the drug use and dosing prescribed for patients with reduced renal function. The objective was to identify the use of renal risk drugs (RRDs) and frequency of drug-related problems (DRPs) in relation to risk rules in RI, establishing the frequency of inappropriate dosing at the time of discharge in accordance with renal function (RF). The prospective study was conducted for a period of 10 months in Rajiv Gandhi Institute of Medical Sciences (RIMS), an 800 bedded tertiary care teaching hospital, Kadapa. A total of 1718 drugs were found to be prescribed for 215 RI patients. Of which 551 were found to be RRDs. 299 (53%) drugs were those that required dosage adjustments, 219 (40%) were drugs to be used with caution and 33 (6%) drugs which were to be avoided. Out of 215 RI patients, 153 patients used 2 or more RRDs and 101 (47 %) had 196 DRPs. Around 26% of the RRDs associated with at least 1 DRPs regard to RF. DRPs were often associated with drugs which are to be avoided. The common drug classes used in RI patients linked to DRPs were Anti-bacterial’s (n=52), ACE inhibitors (n=26), oral hypoglycaemic drugs (n=15), allopurinol (n=12), ranitidine (n=9), aspirin (n=8) and atenolol (n=4). A clinical pharmacist role in a nephrology unit is a valuable asset in monitoring all drug related problems (contraindicated drugs and inadequate dosages), which results in optimization of pharmaceutical care in renal impaired patients.
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