Chronic Kidney Disease Ckd - amazonia.fiocruz.br

Chronic Kidney Disease Ckd Video

Metrics details. People with chronic kidney disease CKD have high levels of co-morbidity and polypharmacy placing them at increased risk of prescribing-related harm. Tools for assessing prescribing safety in the general population using prescribing safety indicators PSIs have been established.

However, people with CKD pose different prescribing challenges to people without kidney disease. A systematic literature search identified papers reporting PSIs.

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Nine thousand, eight hundred fifty-two papers were identified by the systematic literature search, of which proceeded to full text screening and papers were identified as reporting PSIs. Peer Review reports. People with chronic kidney disease CKD stand to benefit from careful prescribing of medications to prevent disease progression, manage comorbidities and relieve symptoms [ 1 ].

Meanwhile they are at increased risk of prescribing-related harm as a result of incorrect dosing considering altered drug clearance or direct nephrotoxicity. Adverse drug events are common in the CKD population and interventions to Chronic Kidney Disease Ckd prescribing have shown promise [ 2 ].

Background

However, current approaches for optimising prescribing in this patient group are limited [ 123 ]. Prescribing safety indicators PSIs distinguish prescribing events that put a patient Diseade risk of harm [ 4 ]. PSI libraries for different patient populations have been collated through expert consensus, review of clinical guidelines, and systematic searching of published literature. One systematic approach to the identification of PSIs conducted by Spencer et al.

WHAT IS CHRONIC KIDNEY DISEASE (CKD)?

Dosease Whilst such a library is applicable to a CKD population, prescribing events of unique importance to people with kidney disease may be inadequately represented when considering pharmacotherapy for this group in isolation. Chronic Kidney Disease Ckd aim of this study was to use a systematic search of the published literature to produce a library of PSIs specific to outpatient prescribing for people with CKD.

This library could be used alone or alongside general PSIs Chronic Kidney Disease Ckd assess the safety and quality of prescribing within a CKD population. A sensitive search strategy was designed to capture all potentially relevant papers reporting PSIs. To capture PSIs from the general primary care population the search strategy used by Spencer et al. Search terms related to three stems — clinical setting, prescribing and tool type. To reflect hospital-based delivery of advanced CKD care, a supplementary CKD-specific search Kiney developed with revision of the clinical setting stem terms, and the addition of a stem for kidney-disease.

This supplementary search was run from inception to Results from the two searches were combined and duplicate results were removed. Titles and abstracts were independently screened by two of the authors FS, GK. If a record was recommended for inclusion by one of the reviewers it progressed to full text screening. Full-text screening was conducted by FS. Publications reporting one or more PSI in the main text, abstract or tables of the publication were included.

The elements extracted included details relating to the publication itself — Kidmey authors; journal; date of publication; study design; setting; target population; methodology and method of indicator development — in addition to exact replication of each PSI from the original publication. The final filter terms were selected once no manually included PSI was excluded by the automated process in a random sample of PSIs.

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Duplicate PSIs and those not meeting pre-specified criteria were manually removed. In order to be classified as duplicates, two PSIs had to replicate the following information: Cjronic drug, identical level of kidney function and identical prescribing rule. Following duplicate removal, it was possible to identify the proportion of PSIs defined Chfonic their ATC classification and subsequently further divide PSIs in relation to the most frequent medication classes.

In total papers were identified by the two searches CKD search ; general population search Of the articles, did not contain any PSIs. Three hundred seventy-one duplicates were identified and excluded. A further 19 were deemed not to fit the pre-specified criteria after discussion between reviewing authors 6 related to inpatient prescribing and 13 were deemed not to be CKD-specific. PSIs were found to take multiple different forms, including those that referred to single drugs Table 1 : Items 1—3to drug classes Item 4and to lists of agents with particular pharmacokinetic or dynamic properties Chronic Kidney Disease Ckd 5.

Some PSIs specified thresholds or ranges of kidney Chronic Kidney Disease Ckd Item 1. Additionally, Table 2 shows the most frequent medication classes referred https://amazonia.fiocruz.br/scdp/blog/woman-in-black-character-quotes/dorothea-lange-s-portrait-of-beauty-and.php in each ATC category. Patients or the public were not involved in the design, or conduct, or reporting, or dissemination plans of our research.]