Renal drug dosage adjustment according to estimated creatinine clearance in hospitalized patients with heart failure

Gokhan Altunbas, Mehmet Yazici, Yalcin Solak, Enes E. Gul, Mehmet Kayrak, Zeynettin Kaya, Hakan Akilli, Alpay Aribas, Abduzhappar Gaipov, Raziye Yazici, Kurtulus Ozdemir

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

It is of clinical importance to determine creatinine clearance and adjust doses of prescribed drugs accordingly in patients with heart failure to prevent untoward effects. There is a scarcity of studies in the literature investigating this issue particularly in patients with heart failure, in whom many have impaired kidney function. The purpose of this study was to determine the degree of awareness of medication prescription as to creatinine clearance in patients hospitalized with heart failure. Patients hospitalized with a diagnosis of heart failure were retrospectively evaluated. Among screened charts, patients with left ventricular ejection fraction <40% and an estimated glomerular filtration rate (eGFR) of ≤50 mL/min were included in the analysis. The medications and respective doses prescribed at discharge were recorded. Medications requiring renal dose adjustment were determined and evaluated for appropriate dosing according to eGFR. A total of 388 patients with concomitant heart failure and renal dysfunction were included in the study. The total number of prescribed medications was 2808 and 48.3% (1357 medications) required renal dose adjustment. Of the 1357 medications, 12.6% (171 medications) were found to be inappropriately prescribed according to eGFR. The most common inappropriately prescribed medications were famotidine, metformin, perindopril, and ramipril. A significant portion of medications used in heart failure requires dose adjustment. Our results showed that in a typical cohort of patients with heart failure, many drugs are prescribed at inappropriately high doses according to creatinine clearance. Awareness should be increased among physicians caring for patients with heart failure to prevent adverse events related to medications.

Original languageEnglish (US)
Pages (from-to)e1004-e1008
JournalAmerican Journal of Therapeutics
Volume23
Issue number4
DOIs
StatePublished - Aug 1 2016

Fingerprint

Creatinine
Heart Failure
Kidney
Social Adjustment
Pharmaceutical Preparations
Glomerular Filtration Rate
Perindopril
Famotidine
Ramipril
Metformin
Stroke Volume
Prescriptions
Physicians

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Pharmacology (medical)

Cite this

Renal drug dosage adjustment according to estimated creatinine clearance in hospitalized patients with heart failure. / Altunbas, Gokhan; Yazici, Mehmet; Solak, Yalcin; Gul, Enes E.; Kayrak, Mehmet; Kaya, Zeynettin; Akilli, Hakan; Aribas, Alpay; Gaipov, Abduzhappar; Yazici, Raziye; Ozdemir, Kurtulus.

In: American Journal of Therapeutics, Vol. 23, No. 4, 01.08.2016, p. e1004-e1008.

Research output: Contribution to journalArticle

Altunbas, G, Yazici, M, Solak, Y, Gul, EE, Kayrak, M, Kaya, Z, Akilli, H, Aribas, A, Gaipov, A, Yazici, R & Ozdemir, K 2016, 'Renal drug dosage adjustment according to estimated creatinine clearance in hospitalized patients with heart failure', American Journal of Therapeutics, vol. 23, no. 4, pp. e1004-e1008. https://doi.org/10.1097/01.mjt.0000434042.62372.49
Altunbas, Gokhan ; Yazici, Mehmet ; Solak, Yalcin ; Gul, Enes E. ; Kayrak, Mehmet ; Kaya, Zeynettin ; Akilli, Hakan ; Aribas, Alpay ; Gaipov, Abduzhappar ; Yazici, Raziye ; Ozdemir, Kurtulus. / Renal drug dosage adjustment according to estimated creatinine clearance in hospitalized patients with heart failure. In: American Journal of Therapeutics. 2016 ; Vol. 23, No. 4. pp. e1004-e1008.
@article{0a188752bfa543eea20f3ab002fbda8b,
title = "Renal drug dosage adjustment according to estimated creatinine clearance in hospitalized patients with heart failure",
abstract = "It is of clinical importance to determine creatinine clearance and adjust doses of prescribed drugs accordingly in patients with heart failure to prevent untoward effects. There is a scarcity of studies in the literature investigating this issue particularly in patients with heart failure, in whom many have impaired kidney function. The purpose of this study was to determine the degree of awareness of medication prescription as to creatinine clearance in patients hospitalized with heart failure. Patients hospitalized with a diagnosis of heart failure were retrospectively evaluated. Among screened charts, patients with left ventricular ejection fraction <40{\%} and an estimated glomerular filtration rate (eGFR) of ≤50 mL/min were included in the analysis. The medications and respective doses prescribed at discharge were recorded. Medications requiring renal dose adjustment were determined and evaluated for appropriate dosing according to eGFR. A total of 388 patients with concomitant heart failure and renal dysfunction were included in the study. The total number of prescribed medications was 2808 and 48.3{\%} (1357 medications) required renal dose adjustment. Of the 1357 medications, 12.6{\%} (171 medications) were found to be inappropriately prescribed according to eGFR. The most common inappropriately prescribed medications were famotidine, metformin, perindopril, and ramipril. A significant portion of medications used in heart failure requires dose adjustment. Our results showed that in a typical cohort of patients with heart failure, many drugs are prescribed at inappropriately high doses according to creatinine clearance. Awareness should be increased among physicians caring for patients with heart failure to prevent adverse events related to medications.",
author = "Gokhan Altunbas and Mehmet Yazici and Yalcin Solak and Gul, {Enes E.} and Mehmet Kayrak and Zeynettin Kaya and Hakan Akilli and Alpay Aribas and Abduzhappar Gaipov and Raziye Yazici and Kurtulus Ozdemir",
year = "2016",
month = "8",
day = "1",
doi = "10.1097/01.mjt.0000434042.62372.49",
language = "English (US)",
volume = "23",
pages = "e1004--e1008",
journal = "American Journal of Therapeutics",
issn = "1075-2765",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Renal drug dosage adjustment according to estimated creatinine clearance in hospitalized patients with heart failure

AU - Altunbas, Gokhan

AU - Yazici, Mehmet

AU - Solak, Yalcin

AU - Gul, Enes E.

AU - Kayrak, Mehmet

AU - Kaya, Zeynettin

AU - Akilli, Hakan

AU - Aribas, Alpay

AU - Gaipov, Abduzhappar

AU - Yazici, Raziye

AU - Ozdemir, Kurtulus

PY - 2016/8/1

Y1 - 2016/8/1

N2 - It is of clinical importance to determine creatinine clearance and adjust doses of prescribed drugs accordingly in patients with heart failure to prevent untoward effects. There is a scarcity of studies in the literature investigating this issue particularly in patients with heart failure, in whom many have impaired kidney function. The purpose of this study was to determine the degree of awareness of medication prescription as to creatinine clearance in patients hospitalized with heart failure. Patients hospitalized with a diagnosis of heart failure were retrospectively evaluated. Among screened charts, patients with left ventricular ejection fraction <40% and an estimated glomerular filtration rate (eGFR) of ≤50 mL/min were included in the analysis. The medications and respective doses prescribed at discharge were recorded. Medications requiring renal dose adjustment were determined and evaluated for appropriate dosing according to eGFR. A total of 388 patients with concomitant heart failure and renal dysfunction were included in the study. The total number of prescribed medications was 2808 and 48.3% (1357 medications) required renal dose adjustment. Of the 1357 medications, 12.6% (171 medications) were found to be inappropriately prescribed according to eGFR. The most common inappropriately prescribed medications were famotidine, metformin, perindopril, and ramipril. A significant portion of medications used in heart failure requires dose adjustment. Our results showed that in a typical cohort of patients with heart failure, many drugs are prescribed at inappropriately high doses according to creatinine clearance. Awareness should be increased among physicians caring for patients with heart failure to prevent adverse events related to medications.

AB - It is of clinical importance to determine creatinine clearance and adjust doses of prescribed drugs accordingly in patients with heart failure to prevent untoward effects. There is a scarcity of studies in the literature investigating this issue particularly in patients with heart failure, in whom many have impaired kidney function. The purpose of this study was to determine the degree of awareness of medication prescription as to creatinine clearance in patients hospitalized with heart failure. Patients hospitalized with a diagnosis of heart failure were retrospectively evaluated. Among screened charts, patients with left ventricular ejection fraction <40% and an estimated glomerular filtration rate (eGFR) of ≤50 mL/min were included in the analysis. The medications and respective doses prescribed at discharge were recorded. Medications requiring renal dose adjustment were determined and evaluated for appropriate dosing according to eGFR. A total of 388 patients with concomitant heart failure and renal dysfunction were included in the study. The total number of prescribed medications was 2808 and 48.3% (1357 medications) required renal dose adjustment. Of the 1357 medications, 12.6% (171 medications) were found to be inappropriately prescribed according to eGFR. The most common inappropriately prescribed medications were famotidine, metformin, perindopril, and ramipril. A significant portion of medications used in heart failure requires dose adjustment. Our results showed that in a typical cohort of patients with heart failure, many drugs are prescribed at inappropriately high doses according to creatinine clearance. Awareness should be increased among physicians caring for patients with heart failure to prevent adverse events related to medications.

UR - http://www.scopus.com/inward/record.url?scp=84887932257&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84887932257&partnerID=8YFLogxK

U2 - 10.1097/01.mjt.0000434042.62372.49

DO - 10.1097/01.mjt.0000434042.62372.49

M3 - Article

C2 - 24263162

AN - SCOPUS:84887932257

VL - 23

SP - e1004-e1008

JO - American Journal of Therapeutics

JF - American Journal of Therapeutics

SN - 1075-2765

IS - 4

ER -