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Published in: BMC Nephrology 1/2017

Open Access 01-12-2017 | Research article

Awareness and knowledge among internal medicine house-staff for dose adjustment of commonly used medications in patients with CKD

Authors: Sikander Surana, Neeru Kumar, Amita Vasudeva, Gulvahid Shaikh, Kenar D. Jhaveri, Hitesh Shah, Deepa Malieckal, Joshua Fogel, Gurwinder Sidhu, Sofia Rubinstein

Published in: BMC Nephrology | Issue 1/2017

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Abstract

Background

Drug dosing errors result in adverse patient outcomes and are more common in patients with chronic kidney disease (CKD). As internists treat the majority of patients with CKD, we study if Internal Medicine house-staff have awareness and knowledge about the correct dosage of commonly used medications for those with CKD.

Methods

A cross-sectional survey was performed and included 341 participants. The outcomes were the awareness of whether a medication needs dose adjustment in patients with CKD and whether there was knowledge for the level of glomerular filtration rate (GFR) a medication needs to be adjusted.

Results

The overall pattern for all post-graduate year (PGY) groups in all medication classes was a lack of awareness and knowledge. For awareness, there were statistically significant increased mean differences for PGY2 and PGY3 as compared to PGY1 for allergy, endocrine, gastrointestinal, and rheumatologic medication classes but not for analgesic, cardiovascular, and neuropsychotropic medication classes. For knowledge, there were statistically significant increased mean differences for PGY2 and PGY3 as compared to PGY1 for allergy, cardiovascular, endocrine, and gastrointestinal, medication classes but not for analgesic, neuropsychotropic, and rheumatologic medication classes.

Conclusions

Internal Medicine house-staff across all levels of training demonstrated poor awareness and knowledge for many medication classes in CKD patients. Internal Medicine house-staff should receive more nephrology exposure and formal didactic educational training during residency to better manage complex treatment regimens and prevent medication dosing errors.
Literature
1.
go back to reference Coresh J, Selvin E, Stevens LA, Manzi J, Kusek JW, Eggers P, Van Lente F, Levey AS. Prevalence of chronic kidney disease in the United States. JAMA. 2007;298(17):2038–47.CrossRefPubMed Coresh J, Selvin E, Stevens LA, Manzi J, Kusek JW, Eggers P, Van Lente F, Levey AS. Prevalence of chronic kidney disease in the United States. JAMA. 2007;298(17):2038–47.CrossRefPubMed
2.
go back to reference Drey N, Roderick P, Mullee M, Rogerson M. A population-based study of the incidence and outcomes of diagnosed chronic kidney disease. Am J Kidney Dis. 2003;42(4):677–84.CrossRefPubMed Drey N, Roderick P, Mullee M, Rogerson M. A population-based study of the incidence and outcomes of diagnosed chronic kidney disease. Am J Kidney Dis. 2003;42(4):677–84.CrossRefPubMed
3.
go back to reference Fox CS, Larson MG, Leip EP, Culleton B, Wilson PW, Levy D. Predictors of new-onset kidney disease in a community-based population. JAMA. 2004;291(7):844–50.CrossRefPubMed Fox CS, Larson MG, Leip EP, Culleton B, Wilson PW, Levy D. Predictors of new-onset kidney disease in a community-based population. JAMA. 2004;291(7):844–50.CrossRefPubMed
4.
go back to reference Coresh J, Astor BC, Greene T, Eknoyan G, Levey AS. Prevalence of chronic kidney disease and decreased kidney function in the adult US population: third national health and nutrition examination survey. Am J Kidney Dis. 2003;41(1):1–12.CrossRefPubMed Coresh J, Astor BC, Greene T, Eknoyan G, Levey AS. Prevalence of chronic kidney disease and decreased kidney function in the adult US population: third national health and nutrition examination survey. Am J Kidney Dis. 2003;41(1):1–12.CrossRefPubMed
5.
go back to reference United States Renal Data System, USRDS 2014 Annual Data Report: CKD in the general population. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2014 United States Renal Data System, USRDS 2014 Annual Data Report: CKD in the general population. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2014
6.
go back to reference Plantinga LC, Crews DC, Coresh J, Miller 3rd ER, Saran R, Yee J, Hedgeman E, Pavkov M, Eberhardt MS, Williams DE, Powe NR, CDC CKD Surveillance Team. Prevalence of chronic kidney disease in US adults with undiagnosed diabetes or prediabetes. Clin J Am Soc Nephrol. 2010;5(4):673–82.CrossRefPubMedPubMedCentral Plantinga LC, Crews DC, Coresh J, Miller 3rd ER, Saran R, Yee J, Hedgeman E, Pavkov M, Eberhardt MS, Williams DE, Powe NR, CDC CKD Surveillance Team. Prevalence of chronic kidney disease in US adults with undiagnosed diabetes or prediabetes. Clin J Am Soc Nephrol. 2010;5(4):673–82.CrossRefPubMedPubMedCentral
7.
go back to reference Garg AX, Papaioannou A, Ferko N, Campbell G, Clarke JA, Ray JG. Estimating the prevalence of renal insufficiency in seniors requiring long-term care. Kidney Int. 2004;65(2):649–53.CrossRefPubMed Garg AX, Papaioannou A, Ferko N, Campbell G, Clarke JA, Ray JG. Estimating the prevalence of renal insufficiency in seniors requiring long-term care. Kidney Int. 2004;65(2):649–53.CrossRefPubMed
8.
go back to reference Hemmelgarn BR, Zhang J, Manns BJ, Tonelli M, Larsen E, Ghali WA, Southern DA, McLaughlin K, Mortis G, Culleton BF. Progression of kidney dysfunction in the community-dwelling elderly. Kidney Int. 2006;69(12):2155–61.CrossRefPubMed Hemmelgarn BR, Zhang J, Manns BJ, Tonelli M, Larsen E, Ghali WA, Southern DA, McLaughlin K, Mortis G, Culleton BF. Progression of kidney dysfunction in the community-dwelling elderly. Kidney Int. 2006;69(12):2155–61.CrossRefPubMed
9.
go back to reference Manjunath G, Tighiouart H, Coresh J, Macleod B, Salem DN, Griffith JL, Levey AS, Sarnak MJ. Level of kidney function as a risk factor for cardiovascular outcomes in the elderly. Kidney Int. 2003;63(3):1121–9.CrossRefPubMed Manjunath G, Tighiouart H, Coresh J, Macleod B, Salem DN, Griffith JL, Levey AS, Sarnak MJ. Level of kidney function as a risk factor for cardiovascular outcomes in the elderly. Kidney Int. 2003;63(3):1121–9.CrossRefPubMed
10.
go back to reference Wasen E, Isoaho R, Mattila K, Vahlberg T, Kivela SL, Irjala K. Estimation of glomerular filtration rate in the elderly: a comparison of creatinine-based formulae with serum cystatin C. J Intern Med. 2004;256(1):70–8.CrossRefPubMed Wasen E, Isoaho R, Mattila K, Vahlberg T, Kivela SL, Irjala K. Estimation of glomerular filtration rate in the elderly: a comparison of creatinine-based formulae with serum cystatin C. J Intern Med. 2004;256(1):70–8.CrossRefPubMed
11.
go back to reference Cheeseman Day J. Population projections of the united states, by age, sex, race, and hispanic origin: 1993 to 2050, current population reports. U S Bureau of the Census. 1993. p. 25–1104. Cheeseman Day J. Population projections of the united states, by age, sex, race, and hispanic origin: 1993 to 2050, current population reports. U S Bureau of the Census. 1993. p. 25–1104.
12.
go back to reference Stevens LA, Li S, Wang C, Huang C, Becker BN, Bomback AS, Brown WW, Burrows NR, Jurkovitz CT, McFarlane SI, Norris KC, Shlipak M, Whaley-Connell AT, Chen SC, Bakris GL, McCullough PA. Prevalence of CKD and comorbid illness in elderly patients in the united states: results from the kidney early evaluation program (KEEP). Am J Kidney Dis. 2010;55(3 Suppl 2):S23–33.CrossRefPubMedPubMedCentral Stevens LA, Li S, Wang C, Huang C, Becker BN, Bomback AS, Brown WW, Burrows NR, Jurkovitz CT, McFarlane SI, Norris KC, Shlipak M, Whaley-Connell AT, Chen SC, Bakris GL, McCullough PA. Prevalence of CKD and comorbid illness in elderly patients in the united states: results from the kidney early evaluation program (KEEP). Am J Kidney Dis. 2010;55(3 Suppl 2):S23–33.CrossRefPubMedPubMedCentral
13.
go back to reference James MT, Laupland KB, Tonelli M, Manns BJ, Culleton BF, Hemmelgarn BR, Alberta Kidney Disease Network. Risk of bloodstream infection in patients with chronic kidney disease not treated with dialysis. Arch Intern Med. 2008;168(21):2333–9.CrossRefPubMed James MT, Laupland KB, Tonelli M, Manns BJ, Culleton BF, Hemmelgarn BR, Alberta Kidney Disease Network. Risk of bloodstream infection in patients with chronic kidney disease not treated with dialysis. Arch Intern Med. 2008;168(21):2333–9.CrossRefPubMed
14.
go back to reference Wong G, Hayen A, Chapman JR, Webster AC, Wang JJ, Mitchell P, Craig JC. Association of CKD and cancer risk in older people. J Am Soc Nephrol. 2009;20(6):1341–50.CrossRefPubMedPubMedCentral Wong G, Hayen A, Chapman JR, Webster AC, Wang JJ, Mitchell P, Craig JC. Association of CKD and cancer risk in older people. J Am Soc Nephrol. 2009;20(6):1341–50.CrossRefPubMedPubMedCentral
15.
go back to reference Bolton WK. Connecting the dots: caring for the patient with progressive CKD. Nephrol News Issues. 2003;17(6):23–8.PubMed Bolton WK. Connecting the dots: caring for the patient with progressive CKD. Nephrol News Issues. 2003;17(6):23–8.PubMed
16.
go back to reference Arora P, Obrador GT, Ruthazer R, Kausz AT, Meyer KB, Jenuleson CS, Pereira BJ. Prevalence, predictors, and consequences of late nephrology referral at a tertiary care center. J Am Soc Nephrol. 1999;10(6):1281–6.PubMed Arora P, Obrador GT, Ruthazer R, Kausz AT, Meyer KB, Jenuleson CS, Pereira BJ. Prevalence, predictors, and consequences of late nephrology referral at a tertiary care center. J Am Soc Nephrol. 1999;10(6):1281–6.PubMed
17.
go back to reference Rifkin DE, Winkelmayer WC. Medication issues in older individuals with CKD. Adv Chronic Kidney Dis. 2010;17(4):320–8.CrossRefPubMed Rifkin DE, Winkelmayer WC. Medication issues in older individuals with CKD. Adv Chronic Kidney Dis. 2010;17(4):320–8.CrossRefPubMed
18.
go back to reference Blix HS, Viktil KK, Moger TA, Reikvam A. Use of renal risk drugs in hospitalized patients with impaired renal function–an underestimated problem? Nephrol Dial Transplant. 2006;21(11):3164–71.CrossRefPubMed Blix HS, Viktil KK, Moger TA, Reikvam A. Use of renal risk drugs in hospitalized patients with impaired renal function–an underestimated problem? Nephrol Dial Transplant. 2006;21(11):3164–71.CrossRefPubMed
19.
go back to reference Long CL, Raebel MA, Price DW, Magid DJ. Compliance with dosing guidelines in patients with chronic kidney disease. Ann Pharmacother. 2004;38(5):853–8.CrossRefPubMed Long CL, Raebel MA, Price DW, Magid DJ. Compliance with dosing guidelines in patients with chronic kidney disease. Ann Pharmacother. 2004;38(5):853–8.CrossRefPubMed
20.
go back to reference Manley HJ, Cannella CA, Bailie GR, St Peter WL. Medication-related problems in ambulatory hemodialysis patients: a pooled analysis. Am J Kidney Dis. 2005;46(4):669–80.CrossRefPubMed Manley HJ, Cannella CA, Bailie GR, St Peter WL. Medication-related problems in ambulatory hemodialysis patients: a pooled analysis. Am J Kidney Dis. 2005;46(4):669–80.CrossRefPubMed
21.
22.
go back to reference Spinewine A, Schmader KE, Barber N, Hughes C, Lapane KL, Swine C, Hanlon JT. Appropriate prescribing in elderly people: how well can it be measured and optimized? Lancet. 2007;370(9582):173–84.CrossRefPubMed Spinewine A, Schmader KE, Barber N, Hughes C, Lapane KL, Swine C, Hanlon JT. Appropriate prescribing in elderly people: how well can it be measured and optimized? Lancet. 2007;370(9582):173–84.CrossRefPubMed
23.
go back to reference Bergman A, Olsson J, Carlsten A, Waern M, Fastbom J. Evaluation of the quality of drug therapy among elderly patients in nursing homes. Scand J Prim Health Care. 2007;25(1):9–14.CrossRefPubMedPubMedCentral Bergman A, Olsson J, Carlsten A, Waern M, Fastbom J. Evaluation of the quality of drug therapy among elderly patients in nursing homes. Scand J Prim Health Care. 2007;25(1):9–14.CrossRefPubMedPubMedCentral
24.
go back to reference Qato DM, Alexander GC, Conti RM, Johnson M, Schumm P, Lindau ST. Use of prescription and over-the-counter medications and dietary supplements among older adults in the United States. JAMA. 2008;300(24):2867–78.CrossRefPubMedPubMedCentral Qato DM, Alexander GC, Conti RM, Johnson M, Schumm P, Lindau ST. Use of prescription and over-the-counter medications and dietary supplements among older adults in the United States. JAMA. 2008;300(24):2867–78.CrossRefPubMedPubMedCentral
25.
go back to reference Schuler J, Duckelmann C, Beindl W, Prinz E, Michalski T, Pichler M. Polypharmacy and inappropriate prescribing in elderly internal-medicine patients in Austria. Wien Klin Wochenschr. 2008;120(23–24):733–41.CrossRefPubMed Schuler J, Duckelmann C, Beindl W, Prinz E, Michalski T, Pichler M. Polypharmacy and inappropriate prescribing in elderly internal-medicine patients in Austria. Wien Klin Wochenschr. 2008;120(23–24):733–41.CrossRefPubMed
26.
go back to reference Bailie GR, Eisele G, Liu L, Roys E, Kiser M, Finkelstein F, Wolfe R, Port F, Burrows-Hudson S, Saran R. Patterns of medication use in the RRI-CKD study: focus on medications with cardiovascular effects. Nephrol Dial Transplant. 2005;20(6):1110–5.CrossRefPubMed Bailie GR, Eisele G, Liu L, Roys E, Kiser M, Finkelstein F, Wolfe R, Port F, Burrows-Hudson S, Saran R. Patterns of medication use in the RRI-CKD study: focus on medications with cardiovascular effects. Nephrol Dial Transplant. 2005;20(6):1110–5.CrossRefPubMed
27.
go back to reference Farag A, Garg AX, Li L, Jain AK. Dosing errors in prescribed antibiotics for older persons with CKD: a retrospective time series analysis. Am J Kidney Dis. 2014;63(3):422–8.CrossRefPubMed Farag A, Garg AX, Li L, Jain AK. Dosing errors in prescribed antibiotics for older persons with CKD: a retrospective time series analysis. Am J Kidney Dis. 2014;63(3):422–8.CrossRefPubMed
28.
go back to reference Hassan Y, Al-Ramahi R, Abd Aziz N, Ghazali R. Drug use and dosing in chronic kidney disease. Ann Acad Med Singapore. 2009;38(12):1095–103.PubMed Hassan Y, Al-Ramahi R, Abd Aziz N, Ghazali R. Drug use and dosing in chronic kidney disease. Ann Acad Med Singapore. 2009;38(12):1095–103.PubMed
29.
go back to reference Lazarou J, Pomeranz BH, Corey PN. Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies. JAMA. 1998;279(15):1200–5.CrossRefPubMed Lazarou J, Pomeranz BH, Corey PN. Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies. JAMA. 1998;279(15):1200–5.CrossRefPubMed
31.
go back to reference Bates DW, Su L, Yu DT, Chertow GM, Seger DL, Gomes DR, Dasbach EJ, Platt R. Mortality and costs of acute renal failure associated with amphotericin B therapy. Clin Infect Dis. 2001;32(5):686–93.CrossRefPubMed Bates DW, Su L, Yu DT, Chertow GM, Seger DL, Gomes DR, Dasbach EJ, Platt R. Mortality and costs of acute renal failure associated with amphotericin B therapy. Clin Infect Dis. 2001;32(5):686–93.CrossRefPubMed
32.
go back to reference Ernst FR, Grizzle AJ. Drug-related morbidity and mortality: updating the cost-of-illness model. J Am Pharm Assoc (Wash). 2001;41(2):192–9.CrossRef Ernst FR, Grizzle AJ. Drug-related morbidity and mortality: updating the cost-of-illness model. J Am Pharm Assoc (Wash). 2001;41(2):192–9.CrossRef
33.
go back to reference American Society of Consultant Pharmacists. Seniors at risk: designing the system to protect America’s most vulnerable citizens from medication related problems. 2004. American Society of Consultant Pharmacists. Seniors at risk: designing the system to protect America’s most vulnerable citizens from medication related problems. 2004.
34.
go back to reference Parker MG, Ibrahim T, Shaffer R, Rosner MH, Molitoris BA. The future nephrology workforce: will there be one? Clin J Am Soc Nephrol. 2011;6(6):1501–6.CrossRefPubMed Parker MG, Ibrahim T, Shaffer R, Rosner MH, Molitoris BA. The future nephrology workforce: will there be one? Clin J Am Soc Nephrol. 2011;6(6):1501–6.CrossRefPubMed
35.
go back to reference Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351(13):1296–305.CrossRefPubMed Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351(13):1296–305.CrossRefPubMed
36.
go back to reference McClellan WM, Resnick B, Lei L, Bradbury BD, Sciarra A, Kewalramani R, Ouslander JG. Prevalence and severity of chronic kidney disease and anemia in the nursing home population. J Am Med Dir Assoc. 2010;11(1):33–41.CrossRefPubMed McClellan WM, Resnick B, Lei L, Bradbury BD, Sciarra A, Kewalramani R, Ouslander JG. Prevalence and severity of chronic kidney disease and anemia in the nursing home population. J Am Med Dir Assoc. 2010;11(1):33–41.CrossRefPubMed
37.
go back to reference Physicians’ Desk Reference, 67th edition. Montvale: PDR Network, LLC; 2012. Physicians’ Desk Reference, 67th edition. Montvale: PDR Network, LLC; 2012.
39.
go back to reference Nasca TJ, Philibert I, Brigham T, Flynn TC. The next GME accreditation system–rationale and benefits. N Engl J Med. 2012;366(11):1051–6.CrossRefPubMed Nasca TJ, Philibert I, Brigham T, Flynn TC. The next GME accreditation system–rationale and benefits. N Engl J Med. 2012;366(11):1051–6.CrossRefPubMed
40.
go back to reference Mark TL, Levit KR, Buck JA. Datapoints: psychotropic drug prescriptions by medical specialty. Psychiatr Serv. 2009;60(9):1167.CrossRefPubMed Mark TL, Levit KR, Buck JA. Datapoints: psychotropic drug prescriptions by medical specialty. Psychiatr Serv. 2009;60(9):1167.CrossRefPubMed
41.
go back to reference Goodwin R, Gould MS, Blanco C, Olfson M. Prescription of psychotropic medications to youths in office-based practice. Psychiatr Serv. 2001;52(8):1081–7.CrossRefPubMed Goodwin R, Gould MS, Blanco C, Olfson M. Prescription of psychotropic medications to youths in office-based practice. Psychiatr Serv. 2001;52(8):1081–7.CrossRefPubMed
42.
go back to reference Hohmann AA, Larson DB, Thompson JW, Beardsley RS. Psychotropic medication prescription in U.S. ambulatory medical care. DICP. 1991;25(1):85–9.PubMed Hohmann AA, Larson DB, Thompson JW, Beardsley RS. Psychotropic medication prescription in U.S. ambulatory medical care. DICP. 1991;25(1):85–9.PubMed
43.
go back to reference Small GW. Psychopharmacological treatment of elderly demented patients. J Clin Psychiatry. 1988;49(Suppl):8–13.PubMed Small GW. Psychopharmacological treatment of elderly demented patients. J Clin Psychiatry. 1988;49(Suppl):8–13.PubMed
44.
go back to reference Katon W, von Korff M, Lin E, Bush T, Ormel J. Adequacy and duration of antidepressant treatment in primary care. Med Care. 1992;30(1):67–76.CrossRefPubMed Katon W, von Korff M, Lin E, Bush T, Ormel J. Adequacy and duration of antidepressant treatment in primary care. Med Care. 1992;30(1):67–76.CrossRefPubMed
45.
go back to reference Cole S, Raju M, Barrett J, Gerrity M, Dietrich A. The MacArthur foundation depression education program for primary care physicians: background and rationale. Gen Hosp Psychiatry. 2000;22(5):299–358.CrossRefPubMed Cole S, Raju M, Barrett J, Gerrity M, Dietrich A. The MacArthur foundation depression education program for primary care physicians: background and rationale. Gen Hosp Psychiatry. 2000;22(5):299–358.CrossRefPubMed
46.
go back to reference Eisenberg L. Treating depression and anxiety in primary care. Closing the gap between knowledge and practice. N Engl J Med. 1992;326(16):1080–4.CrossRefPubMed Eisenberg L. Treating depression and anxiety in primary care. Closing the gap between knowledge and practice. N Engl J Med. 1992;326(16):1080–4.CrossRefPubMed
47.
go back to reference Kroenke K, Taylor-Vaisey A, Dietrich AJ, Oxman TE. Interventions to improve provider diagnosis and treatment of mental disorders in primary care. A critical review of the literature. Psychosomatics. 2000;41(1):39–52.CrossRefPubMed Kroenke K, Taylor-Vaisey A, Dietrich AJ, Oxman TE. Interventions to improve provider diagnosis and treatment of mental disorders in primary care. A critical review of the literature. Psychosomatics. 2000;41(1):39–52.CrossRefPubMed
48.
go back to reference Schurman RA, Kramer PD, Mitchell JB. The hidden mental health network. treatment of mental illness by nonpsychiatrist physicians. Arch Gen Psychiatry. 1985;42(1):89–94.CrossRefPubMed Schurman RA, Kramer PD, Mitchell JB. The hidden mental health network. treatment of mental illness by nonpsychiatrist physicians. Arch Gen Psychiatry. 1985;42(1):89–94.CrossRefPubMed
49.
go back to reference Centers for Disease Control and Prevention. National vital stats report. Deaths: preliminary data for 2011. 2012;61(6):1-51. Centers for Disease Control and Prevention. National vital stats report. Deaths: preliminary data for 2011. 2012;61(6):1-51.
50.
go back to reference Pfuntner A, Wier L, Stocks C. Most frequent conditions in U.S. hospitals, 2010. HCUP Statistical Brief #148 2013 Jan. Rockville: Agency for Healthcare Research and Quality; 2010. Pfuntner A, Wier L, Stocks C. Most frequent conditions in U.S. hospitals, 2010. HCUP Statistical Brief #148 2013 Jan. Rockville: Agency for Healthcare Research and Quality; 2010.
51.
go back to reference Centers for Medicare & Medicaid Services (CMS) and the Joint Commission. Specifications manual for national hospital inpatient quality measure. 2015. Centers for Medicare & Medicaid Services (CMS) and the Joint Commission. Specifications manual for national hospital inpatient quality measure. 2015.
52.
go back to reference Hetterich N, Lauterbach E, Sturer A, Weilemann LS, Lauterbach M. Toxicity of antihypertensives in unintentional poisoning of young children. J Emerg Med. 2014;47(2):155–62.CrossRefPubMed Hetterich N, Lauterbach E, Sturer A, Weilemann LS, Lauterbach M. Toxicity of antihypertensives in unintentional poisoning of young children. J Emerg Med. 2014;47(2):155–62.CrossRefPubMed
53.
go back to reference Thurston MM, Phillips BB, Bourg CA. Safety and efficacy of allopurinol in chronic kidney disease. Ann Pharmacother. 2013;47(11):1507–16.CrossRefPubMed Thurston MM, Phillips BB, Bourg CA. Safety and efficacy of allopurinol in chronic kidney disease. Ann Pharmacother. 2013;47(11):1507–16.CrossRefPubMed
54.
go back to reference Wallace SL, Omokoku B, Ertel NH. Colchicine plasma levels. Implications as to pharmacology and mechanism of action. Am J Med. 1970;48(4):443–8.CrossRefPubMed Wallace SL, Omokoku B, Ertel NH. Colchicine plasma levels. Implications as to pharmacology and mechanism of action. Am J Med. 1970;48(4):443–8.CrossRefPubMed
55.
go back to reference Baud FJ, Sabouraud A, Vicaut E, Taboulet P, Lang J, Bismuth C, Rouzioux JM, Scherrmann JM. Brief report: treatment of severe colchicine overdose with colchicine-specific fab fragments. N Engl J Med. 1995;332(10):642–5.CrossRefPubMed Baud FJ, Sabouraud A, Vicaut E, Taboulet P, Lang J, Bismuth C, Rouzioux JM, Scherrmann JM. Brief report: treatment of severe colchicine overdose with colchicine-specific fab fragments. N Engl J Med. 1995;332(10):642–5.CrossRefPubMed
56.
go back to reference Kuncl RW, Duncan G, Watson D, Alderson K, Rogawski MA, Peper M. Colchicine myopathy and neuropathy. N Engl J Med. 1987;316(25):1562–8.CrossRefPubMed Kuncl RW, Duncan G, Watson D, Alderson K, Rogawski MA, Peper M. Colchicine myopathy and neuropathy. N Engl J Med. 1987;316(25):1562–8.CrossRefPubMed
57.
go back to reference Accreditation Council for Graduate Medical Education. ACGME data resource book academic year 2012–2013. Sep 2013. Accreditation Council for Graduate Medical Education. ACGME data resource book academic year 2012–2013. Sep 2013.
58.
go back to reference Ellaway RH, Fink P, Graves L, Campbell A. Left to their own devices: medical learners’ use of mobile technologies. Med Teach. 2014;36(2):130–8.CrossRefPubMed Ellaway RH, Fink P, Graves L, Campbell A. Left to their own devices: medical learners’ use of mobile technologies. Med Teach. 2014;36(2):130–8.CrossRefPubMed
59.
go back to reference Bobb A, Gleason K, Husch M, Feinglass J, Yarnold PR, Noskin GA. The epidemiology of prescribing errors: the potential impact of computerized prescriber order entry. Arch Intern Med. 2004;164(7):785–92.CrossRefPubMed Bobb A, Gleason K, Husch M, Feinglass J, Yarnold PR, Noskin GA. The epidemiology of prescribing errors: the potential impact of computerized prescriber order entry. Arch Intern Med. 2004;164(7):785–92.CrossRefPubMed
60.
go back to reference Dean B, Schachter M, Vincent C, Barber N. Prescribing errors in hospital inpatients: their incidence and clinical significance. Qual Saf Health Care. 2002;11(4):340–4.CrossRefPubMedPubMedCentral Dean B, Schachter M, Vincent C, Barber N. Prescribing errors in hospital inpatients: their incidence and clinical significance. Qual Saf Health Care. 2002;11(4):340–4.CrossRefPubMedPubMedCentral
Metadata
Title
Awareness and knowledge among internal medicine house-staff for dose adjustment of commonly used medications in patients with CKD
Authors
Sikander Surana
Neeru Kumar
Amita Vasudeva
Gulvahid Shaikh
Kenar D. Jhaveri
Hitesh Shah
Deepa Malieckal
Joshua Fogel
Gurwinder Sidhu
Sofia Rubinstein
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Nephrology / Issue 1/2017
Electronic ISSN: 1471-2369
DOI
https://doi.org/10.1186/s12882-017-0443-7

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