| Renal impairment alters pharmacokinetics of drugs, plasma drug levels, drug interactions, and adverse reactions which are related to accumulation of renal-eliminating drugs. Thus, appropriatedose adjustment is required in patients with reduced renal function to avoid any drug interactions and unwanted outcomes.Objectives:The aims of this study were to assess whether appropriatedosage adjustment and the number of medications that were prescribed in hospitalized patients with renal impairment. Methods: A retrospective study was carried out in the internal medicine wards of SunpasitHospital. We included18 year-old or older patients who admitted to hospital with eGFR <60 ml/min/1.73m2 or acute kidney injurypatients following AKIN criteriabetween January to December 2015. Also, the patient must receive at least one drugthat is required renal dose adjustment. Potentially inappropriate renal dose adjustment was reported by using descriptive statistic, frequency and percentage. Results:Our study found that 674 from 2326 items (29.0%) of drugs from total 236 patients in which dosage adjustment was required. 173 (25.7%) itemswere not renally adjustedsuch asacyclovir, cyclosporinanddesmopressineach100%.486 (72.1%) itemswere adjusted appropriately and15 (2.2%) items were found to have potentially inappropriate dosage adjustmentincludingcefdinir 100%, cefazolin andimipenem each20%.Conclusion: Despite the laboratory results indicatedeclined kidney function, inappropriate renal dose adjustment still occurs. In the patient care team, clinical pharmacistshave a crucialroletohelp on drug use process to enhance patient safety especially in renal impairment patients.This study also suggeststhat the development of electronictools canassistthemedical staffto provide the safest care to patients. |