慢性肾脏病患者铁剂的利用评价及安全性分析

Application evaluation and safety analysis of iron agent used in patients with chronic kidney disease

目的:评价铁剂在慢性肾脏病(chronic kidney disease,CKD)患者使用中的合理性,为CKD5/5D期患者安全使用提供数据。方法:回顾性分析了苏州大学附属第一医院(下称“我院”)2020年出院的CKD患者的真实世界数据,制定铁剂使用规范,对使用铁剂的患者进行合理性评价,特别对CKD5/5D期患者使用铁剂的安全性进行了评估。结果:共纳入254例患者,铁剂使用合理率为67.3%,潜在药物相互作用(drug-drug interactions,DDI)发生率72%,铁剂总ADR发生率为10.2%,CKD1~4期和CKD5/5D期ADR发生率分别为11.8%和10.0%(P>0.05)。存在潜在DDI的ADR发生率和无潜在DDI的ADR发生率分别为12%和5.6%(P>0.05)。结论:我院CKD患者铁剂使用较为合理,CKD5/5D期患者使用铁剂安全性较高,DDI方面需要做好用药交代。

OBJECTIVE To evaluate the rationality of iron agent used in patients with chronic kidney disease(CKD),and provide data for its safe use in CKD5/5D patients.METHODS The real world data of CKD patients discharged from the First Affiliated Hospital of Soochow University(hereinafter referred to as“our hospital”)in2020 were retrospectively analyzed,and the guidelines for iron agent use in our hospital were formulated to evaluate the rationality of iron agent used in patients,especially the safety in CKD5/5D patients.RESULTS A total of 254 patients were included in the study.The rational rate of iron agent use was 67.3%,the incidence of potential drug interactions was 72%,the incidence of iron agent ADRs was 10.2%,the incidence of CKD1-4 and CKD5/5D ADRs was 11.8%and 10.0%,respectively(P>0.05),and the incidence of DDI ADRs and non-DDI ADRs was 12%and 5.6%,respectively(P>0.05).CONCLUSION The use of iron agent in patients with CKD in our hospital is reasonable,that in patients with CKD5/5D stage is relatively safe,and DDI needs to be explained well.