One of our customers, the leading Estonian hospital North Estonia Medical Centre, was a finalist in the Estonian Association of Quality Annual Award (2018) for drug dosing service implementation.
Drug dosing in kidney failure is a significant clinical problem that can be prevented by clinical decision support
In patients with impaired renal function, drug dose adjustment is often required. Non-adherence to clinical prescribing recommendations may result in severe adverse events. Clinical problem26% of all hospitalizations caused by adverse drug reactions (ADRs) in Karolinska University Hospital were linked to drug dose in renal drugs
26% of drug-related problems for patients with GFR <60 ml/min were caused by renal risk drugs (drug classes eliminated through renal excretion when they are to be used in patients with renal impairment)
Integrate drug dosing tool in renal failure into your clinical workflow with Synbase
Synbase platform enables the integration of drug dosing tools in kidney failure into your electronic health record and the use of a complimentary web portal. #1 clinical decision support platform
Features of Synbase platform for implementing drug dosage in renal failure database:
- Gives drug dosage recommendations based on the degree of renal failure, including dialysis patients
- Includes data on the nephrotoxicity of the drug
- Maps drugs with local drug compendium
- Takes drug administration route into account
- Is integrated with other drug databases (e.g., drug interactions or drug warnings in pregnancy and lactation)
- Supports search with local trade name, active substance, and ATC code
- Considers both prescription and over-the-counter (OTC) medication
- Can be used in a desktop, tablet, or mobile application.
Recognition for implementing drug dosage service
RecognitionRenbase database on drug dosage in kidney failure provides warnings from mild renal failure to end-stage renal disease and dialysis patients
Clinical databaseDrug dosage in renal failure database
Renbase database includes concise, up-to-date information on the safety and detailed recommendations of 1 700 drugs and other substances, such as vitamins and micronutrients, in patients with renal failure.
The database provides quick access to information on safe and effective medication use in patients with kidney failure. The database gives numeric drug dose recommendations on each degree of renal failure (mild, moderate, severe, end-stage, or dialysis).
In addition, the database includes a description of the documentation, possible indication or dialysis method-specific instructions for dosage modification, as well as specific instructions for patient monitoring. The dosage form in dosing is always considered. The user can estimate GFR based on serum creatinine concentration, age, and sex. Afterward, the searches are made and pointed automatically to the right degree of kidney failure. The database also contains a warning on the possible nephrotoxicity of the drug.
Drug information has been produced according to standard operating procedures (SOPs), including published medical knowledge and the manufacturer-provided information approved by the EMA and/or The United States Food and Drug Administration (FDA) and information from national drug registers. All references are linked to their source evidence.
Methodology of drug dosing in renal failure database
The database uses the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine level equation to calculate GFR.
In the database, the degree of renal failure, based on glomerular filtration rate (GFR), is divided into four categories, according to the classification by the European 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 |
The database is not suitable for patients with acute kidney disease.
The safety and need for dosage recommendations are classified into four different categories (A to D), resulting in a traffic light-like system:
|
A |
No need for dosage modification |
|
B |
The information is not available, or the recommendation is estimated based on the pharmacokinetic characteristics of the substance |
|
C |
Modification of the dose or dosage interval is needed |
|
D |
The use of this drug in CKD patients should be avoided |
For categories B and C, a piece of detailed numerical information on the magnitude of dosage modification is provided whenever available.
Regular updates for drug dosing in renal failure database
Up-to-date information to provide medical advice – the drug dosage in renal failure database Renbase is developed and updated quarterly by Medbase (Finland).
