Adjusting the dosage of medication in institutionalised elderly patients with renal failure

Objective

To design a programme for pharmaceutical care for the elderly with renal failure in 3 nursing homes in the region of Valencia.

Method

A 9-month long, prospective study into pharmaceutical interventions was carried out. The study assessed the development of renal function and the effectiveness of drug dosage adjustment with pharmacokinetics affected by renal failure in patients with creatinine clearance below 30 mL/min.

Results

Fifty-two residents of 251 centres presented creatinine clearance lower than 30 mL/ min. Forty-seven out of 74 pharmaceutical interventions were accepted. The drugs which were mainly used were: diuretics, antibiotics, anti-inflammatories, antiemetics, and ranitidine. Although the process of renal disease continued its course, in most cases the follow-up parameters of effectiveness and safety (in terms of renal toxicity) were maintained within the established limits.

Conclusion

The interventions carried out showed, in most cases, to be safe (renal toxicity) and effective, with some exceptions which required more individual follow-up.