Prescribing information for kidney disease far too vague

December 06, 2006

Prescribing information for healthcare professionals treating patients with kidney disease is too vague, concludes the latest issue of Drug and Therapeutics Bulletin (DTB).

Many of the 4-5% of the UK population with serious chronic kidney disease are elderly people, who are often taking several different drugs. Other risk factors for the disease include diabetes and high blood pressure.

The effectiveness of certain drugs is altered by impaired kidney function, while others can significantly boost the chances of kidney damage.

Examples include several drugs used for cardiovascular problems, some painkillers, some antidepressants, several antibiotics, as well as certain drugs to suppress the immune system and antiviral therapies.

People with kidney disease tend to run a greater risk of experiencing harmful effects from certain drugs. And they will often require changes in the normally prescribed dose and frequency, says DTB

Healthcare professionals therefore need practical information on whether or how to use drugs that can cause, or be altered by chronic kidney disease. Product information that simply advises: 'use with caution' is not enough, says DTB. It needs to be made more specific.

Comments DTB editor, Ike Iheanacho:

"The advice for [chronic kidney disease] is often unhelpful, for example, stating that drugs should be used 'with caution' without explaining what this means. Possibilities include starting with a lower dose of the drug, and/or increasing the dose more gradually, and/or monitoring renal function more frequently."

"This lack of practical advice can cause difficulties for both prescribers and patients," he adds.

BMJ Specialty Journals

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