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首页> 外文期刊>Integrated Pharmacy Research and Practice >Clinical relevancy and determinants of potential drug–drug interactions in chronic kidney disease patients: results from a retrospective analysis
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Clinical relevancy and determinants of potential drug–drug interactions in chronic kidney disease patients: results from a retrospective analysis

机译：慢性肾脏病患者的临床相关性和潜在药物相互作用的决定因素：回顾性分析结果

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Background: Chronic kidney disease (CKD) alters the pharmacokinetic and pharmacodynamic responses of various renally excreted drugs and increases the risk of drug-related problems, such as drug–drug interactions. Objectives: To assess the pattern, determinants, and clinical relevancy of potential drug–drug interactions (pDDIs) in CKD patients. Materials and methods: This study retrospectively reviewed medical charts of all CKD patients admitted in the nephrology unit of a tertiary care hospital in Pakistan from January 2013 to December 2014. The Micromedex Drug-Reax? system was used to screen patient profiles for pDDIs, and IBM SPSS version 20 was used to carry out statistical analysis. Results: We evaluated 209 medical charts and found pDDIs in nearly 78.5% CKD patients. Overall, 541 pDDIs were observed, of which, nearly 60.8% patients had moderate, 41.1% had minor, 27.8% had major, and 13.4% had contraindicated interactions. Among those interactions, 49.4% had good evidence, 44.0% had fair, 6.3% had excellent evidence, and 35.5% interactions had delayed onset of action. The potential adverse outcomes of pDDIs included postural hypotension, QT prolongation, ceftriaxone–calcium precipitation, cardiac arrhythmias, and reduction in therapeutic effectiveness. The occurrence of pDDIs was found strongly associated with the age of <60 years, number of prescribed medicines ≥5, hypertension, and the lengthy hospitalization of patients. Conclusion: The occurrence of pDDIs was high in CKD patients. It was observed that CKD patients with an older age, higher number of prescribed medicines, lengthy hospitalization, and hypertension were at a higher risk of pDDIs.
机译：背景：慢性肾脏病（CKD）改变了各种肾脏排泄药物的药代动力学和药效动力学反应，并增加了与药物有关的问题（如药物相互作用）的风险。目的：评估CKD患者潜在药物相互作用的模式，决定因素和临床相关性。资料和方法：本研究回顾性回顾了2013年1月至2014年12月在巴基斯坦三级护理医院肾脏病科收治的所有CKD患者的病历。使用Micromedex Drug-Reax ？系统筛选pDDI的患者资料，并使用IBM SPSS 20版进行统计分析。结果：我们评估了209个医学图表，并在将近78.5％的CKD患者中发现了pDDI。总体上，观察到541个pDDI，其中近60.8％的患者为中度，41.1％的患者为轻度，27.8％的患者为重度，13.4％的患者有禁忌症。在这些相互作用中，有49.4％的证据良好，44.0％的证据公正，6.3％的证据很好，并且35.5％的相互作用延迟了起效。 pDDI的潜在不良后果包括体位性低血压，QT延长，头孢曲松钙沉淀，心律不齐和治疗效果降低。发现pDDI的发生与年龄小于60岁，处方药数量≥5，高血压和患者长期住院密切相关。结论：CKD患者中pDDI的发生率较高。据观察，年龄较大，处方药数量较多，住院时间较长和高血压的CKD患者患pDDI的风险较高。

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