Pitfalls of the Application of the Modification of Diet in Renal Disease Equation to Drug-Dosing Practices: A Tertiary Care Teaching Hospital Experience
Restricted accessResearch articleFirst published online July, 2008
Pitfalls of the Application of the Modification of Diet in Renal Disease Equation to Drug-Dosing Practices: A Tertiary Care Teaching Hospital Experience
Medications that are predominantly renally eliminated can result in accumulation and/or toxic adverse effects if prescribed in normal doses to a patient with renal dysfunction. Methods including mathematical formulas such as the Cockcroft-Gault equation have been used to estimate renal function. The Modification of Diet in Renal Disease (MDRD) equation has proven useful in staging the degree of renal dysfunction that a patient may have. However, the application of the MDRD equation for the purpose of determining drug dosage adjustments in patients with renal dysfunction has not yet been validated. Several examples are reported that depict how the use of the MDRD equation for the basis of drug dosing could lead to negative patient outcomes. The process undertaken at our institution to implement a policy prohibiting the use of the MDRD equation for the purpose of drug-dosing adjustments is described.
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