Non-adjustment of drug dosing in renal failure is a major health problem
It has been estimated that 25-35% of the population over 65 years of age suffers from reduced kidney function GFR < 60 ml/min. In Sweden a study indicated non-adjustment of the drug dose as the most important single reason behind admission to hospital due to adverse drug reaction. This really not surprising, considering the existing evidence on the subject. Recently, a study done using renbase in Denmark, indicated similar results, albeit the somewhat lower frequency of dosing problems in patients with renal failure. Another unpublished observation comes from Finland indicating that in a virtual health check of the population a whole small city in Finland employing Duodecim EBMeDS decision support module, about 1000 patients out of 16.000 had some kind of problem in their drug treatment due to renal failure.
Considering the information above, it is fair to state that renal failure is unrecognized and sometimes even neglected issue in drug treatment. It is important that the laboratories that answer the plasma creatinine values have already calculated GFR values for individual patients. Renbase offers then fully evidence based information on dosing instructions when the kidney function is reduced. Importantly, among the different therapeutic drug groups there is almost always some drug which is well documented for its dosage in various degrees of renal failure