Drug management in acute kidney disease - Report of the Acute Disease Quality Initiative XVI meeting.

摘要: AIMS To summarize and extend the main conclusions recommendations relevant to drug management during acute kidney disease (AKD) as agreed at 16th Acute Disease Quality Initiative (ADQI) consensus conference. METHODS Using a modified Delphi method achieve consensus, experts attending t he 16thADQI conference reviewed appraised existing literature on AKD identified for clinical practice future research. The group focussed drugs with one of following characteristics: (i) predominant renal excretion; (ii) nephrotoxicity; (iii) potential alter glomerular function; (iv) presence metabolites that are in may affect other organs. RESULTS We recommend medication reconciliation should occur admission discharge, diagnosis change phase, when patient ’s condition changes. Strategies avoid adverse reactions seek minimize events from overdosing nephrotoxicity therapeutic failure under-dosing or incorrect selection. Medication regimen assessment introduction medications period consider nephrotoxic potential, altered non elimination, effects toxic interactions pharmacodynamics AKD. A dynamic monitoring plan including repeated serial features, utilization diagnostic tests be used guide assessment. CONCLUSIONS Drug different phases requires an individualized approach frequent re-assessment. More research is needed associated harm failure.