Review Article: Analisis Dan Identifikasi Drug-Related Problems (DRPs) Pada Terapi Pasien Penyakit Ginjal Kronis Di Rawat Inap

Abstract

Chronic kidney disease (CKD) is a progressive condition that causes changes in excretory, metabolic, fluid, and electrolyte regulation functions, requiring many patients to receive complex drug therapy. Polypharmacy, comorbidities, altered pharmacokinetics, and the need for dose adjustment according to renal function increase the risk of Drug-Related Problems (DRPs). This article aims to review and analyze the patterns of DRPs in patients with CKD, particularly those receiving hospital care, based on published research. A narrative review was conducted by searching scientific articles addressing DRPs in CKD patients and related complication groups through several electronic databases. Eligible literature was assessed according to study characteristics, DRP identification methods, types of problems, causes, and implications for treatment. The review indicates that DRPs are frequently identified among patients with CKD, although the patterns vary across studies. Recurrent problems include inappropriate drug selection, inappropriate dosing or inadequate renal dose adjustment, untreated indications, treatment without indication, drug interactions, and problems related to treatment safety and effectiveness. Comorbidities, number of medications, CKD stage, and length of hospital stay are also associated with a higher risk of DRPs. Clinical pharmacist involvement through medication review, medication therapy monitoring, medication reconciliation, and pharmaceutical interventions is therefore needed to identify and resolve DRPs and improve the safety and effectiveness of pharmacotherapy in patients with CKD.