Drug use and dosage in renal failure
The prevalence of chronic kidney disease is increasing. In the US, 13.9% of the adult population are estimated to have renal failure to some degree (1). Renal failure is recognised as a major risk factor for adverse drug reactions, particularly those related to altered drug excretion. Severe renal failure increases the risk of serious adverse drug reaction by more than 80%, compared to less severe renal failure or normal renal function (2).
Adverse drug reactions also constitute a major cause for hospitalisation in patients with chronic kidney disease (3). Approximately one-third of adverse drug reactions attributed to renal failure are considered preventable (2,3). Multiple aspects of drug therapy should be considered when treating patients with renal failure.
80%
“Severe renal failure increases the risk of serious adverse drug reaction by more than 80%.“
Clinical solution
The core purpose of Renbase is to provide the user with all necessary information on drug therapy relevant when treating patients with renal failure. Our objective is to minimise the risk for inadequate dosing or inappropriate use of drugs in these patients, as well as to guide the user in taking all safety measures into account.
Key characteristics
of Renbase
- Analysis of the pharmacokinetics and safety of drugs during renal failure
- Dosing recommendations for four categories of renal failure, based on classification by the European Medicines Agency (EMA)
- Indications of potential nephrotoxicity and evaluation of need for laboratory or clinical monitoring
Classification methodology
Classification of renal failure
In Renbase, the degree of renal failure, based on glomerular filtration rate (GFR), is divided into four categories, according to the classification by the Europan Medicines Agency (EMA):
GFR 60- <90 ml/min | Mild renal failure | |
GFR 30- <60 ml/min | Moderate renal failure | |
GFR 15- <30 ml/min | Severe renal failure | |
GFR <15 ml/min | End-stage renal failure; dialysis patient |
Classification of dosing recommendations
The safety and need for dosage modifications are classified into four categories (A–D), clarified by a traffic light-like system:
D | The use should be avoided |
C | Modification of the dose or dosing interval is needed |
B | The information is not available, or the recommendation is estimated based on the pharmacologic characteristics of the substance |
A | No need for dosing modification |
Languages and local drug registries
Medbase content is available in English and more than ten additional languages. To further improve local usability, we accommodate national, local and customer-specific drug product registries, allowing access to information using local drug product names and IDs.
Integration with local electronic health record (EHR) systems is straightforward, enabling smooth and efficient use of regularly updated Medbase drug information across various countries.
Latest information from trusted sources
All information is based on scientific evidence. We refer to published, peer-reviewed research articles from PubMed, a reliable source of biomedical and life sciences literature, as well as regulatory authority approved documents, such as the Summaries of Product Characteristics (SPC) of drugs.
Medbase Knowledgebase is continuously updated to ensure the inclusion of the latest information.
Supporting informed decisions for safe drug use
Enhanced patient safety
Holistic approach to patient’s pharmacotherapy enabling individualised drug treatment.
100% Evidence-based
Fully referenced information with transparency to original sources: documents approved by regulatory authorities and peer-reviewed literature.
Clinical relevance
We provide comprehensive and concise information for safe use of drugs, accessible from one single source.
Digitalised doctor consultation
Designed to support busy clinical practice for safe use of drugs. All information is created and validated by physicians specialised in clinical pharmacology.
“In the face of compromised kidneys, adjusting medication is key. Dosing strategies informed by renal function ensure optimal treatment while minimising risks.”
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- Centers for Disease Control and Prevention. (2022). Chronic kidney disease in the United States. Centers for Disease Control and Prevention. https://www.cdc.gov/kidneydisease/index.html
- Laville et al. Adverse drug reactions in patients with CKD. Clin J Am Soc Nephrol. 15(8): 1090–1102
- Laville et al. Kidney Function Decline and Serious Adverse Drug Reactions in Patients With CKD. American Journal of Kidney Diseases. 83(5): 601-614