Medication errors frequently occur in the treatment of patients with renal insufficiency and can cause serious adverse events. Although computerized systems that adjust the drug dose on the basis of a patient's glomerular filtration rate can reduce the incidence and severity of drug prescription errors, other variables can also affect the susceptibility of patients with renal dysfunction to drug toxicity.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Hug, B. L. et al. Occurrence of adverse, often preventable, events in community hospitals involving nephrotoxic drugs or those excreted by the kidney. Kidney Int. 76, 1192–1198 (2009).
Chertow, G. M. et al. Guided medication dosing for inpatients with renal insufficiency. JAMA 286, 2839–2844 (2001).
Colpaert, K. et al. Impact of computerized physician order entry on medication prescription errors in the intensive care unit: a controlled cross-sectional trial. Crit. Care 10, R21 (2006).
Fink, J. C. & Chertow, G. M. Medication errors in chronic kidney disease: one piece in the patient safety puzzle. Kidney Int. 76, 1123–1125 (2009).
Verbeeck, R. K. & Musuamba, F. T. Pharmacokinetics and dosage adjustment in patients with renal dysfunction. Eur. J. Clin. Pharmacol. 65, 757–773 (2009).
Gabardi, S. & Abramson, S. Drug dosing in chronic kidney disease. Med. Clin. North Am. 89, 649–687 (2005).
Tavares-Almeida, I., Gulyassy, P. F., Depner, T. A. & Jarrard, E. A. Aromatic amino acid metabolites as potential protein binding inhibitors in human uremic plasma. Biochem. Pharmacol. 34, 2431–2438 (1985).
Pedone, C. et al. Reliability of equations to estimate glomerular filtration rate in the very old. Aging Clin. Exp. Res. 20, 496–502 (2008).
Pratt, N., Roughead, E. E., Ryan, P. & Gilbert, A. L. Differential impact of NSAIDs on rate of adverse events that require hospitalization in high-risk and general veteran populations: a retrospective cohort study. Drugs Aging 27, 63–71 (2010).
Karras, A., Martinez, F. & Droz, D. in Oxford Text of Clinical Nephrology. Acute tubulointerstitial nephritis (eds Davison, A. M. et al.) 1531–1544 (Oxford University Press, Oxford, UK, 2005).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
C. Ponticelli declares an association with the following company: Novartis, as consultant. G. Graziani declares no competing interests.
Rights and permissions
About this article
Cite this article
Ponticelli, C., Graziani, G. Management of drug toxicity in patients with renal insufficiency. Nat Rev Nephrol 6, 317–318 (2010). https://doi.org/10.1038/nrneph.2010.43
Issue Date:
DOI: https://doi.org/10.1038/nrneph.2010.43