MANAGING MEDICATION IN PATIENTS WITH RENAL IMPAIRMENT

Dr. S. Sudeesh*, Dr. P. Prabakar, M. Priyanka

Chronic kidney disease (CKD) is associated with significant alterations in drug pharmacokinetics and pharmacodynamics, which increase the risk of medication-related complications and therapeutic challenges. The present study was conducted to evaluate medication management practices in patients with renal impairment, with particular emphasis on prescribing patterns, dose adjustment practices, and the relationship between renal function and clinical parameters. A prospective observational approach was adopted, and relevant data including patient demographics, comorbid conditions, laboratory findings, and prescribed medications were systematically collected and analyzed. Renal function was assessed using standard indicators such as serum creatinine and estimated glomerular filtration rate (eGFR). Statistical analysis was performed using SPSS version 16.0, applying descriptive statistics, one-way ANOVA, chi-square test, and cross-tabulation methods to determine associations between variables. The findings demonstrated a high prevalence of polypharmacy among CKD patients, along with variable adherence to renal dose adjustment guidelines. Although commonly prescribed therapies such as erythropoietin, iron supplementation, and antihypertensive agents were appropriately utilized in many cases, instances of inappropriate dosing and continued use of potentially nephrotoxic drugs were identified. A statistically significant association between CKD stage and serum creatinine levels was observed, highlighting the importance of renal function–based dose modification. Furthermore, gaps in medication adherence and lifestyle practices were evident among patients. Overall, the study underscores the importance of rational prescribing, individualized dose adjustment, and continuous monitoring to ensure safe and effective pharmacotherapy in patients with renal impairment, and emphasizes the need for enhanced clinical awareness, multidisciplinary involvement, and adherence to evidence-based guidelines to improve patient outcomes.