Drugs that are eliminated primarily by renal excretion would accumulate
excessively in patients with renal insufficiency. Undesirable side effects and/or
toxicity will be produced unless the dosage regimens are modified. Some hospitals in
Tripoli (Libya) were selected to investigate how drug doses being adjusted in
patients with renal insufficiency. A total of 798 files were reviewed, data from renal
insufficiency patient's files were collected and creatinine clearance was estimated.
The results revealed that, the issue of dosage adjustment for renal insufficiency
patients has not been put in prospective at the hospitals involved in this study. It was
found that 61%, 47% and 62% of drugs that have to be adjusted were administered in
the normal dose to patients with renal insufficiency at Tripoli Medical Center, Tripoli
Kidney Center and Tripoli Diabetic Center, respectively. It is concluded that serum
creatinine concentration test is a must to be performed, for making the dose
adjustment of drugs possible in case of renal insufficiency. Including clinical
pharmacist as a member of the medical team has an important role in checking out
the drugs administered, dosing and dosing interval.
Keywords: Renal impairment, dose adjustment, renal insufficiency, renal failure,
Libya