Attention! Elderly kidney disease patients have to pay attention to medication.

Introduction: The elderly often have varying degrees of renal function decline, easy to cause drug accumulation in the body.
know that most of the drugs are excreted through the kidneys, and a small number of drugs are excreted from the liver through the bile detential intestinal intestinal intestinal bodies and then from the feces.
The elderly, especially those with kidney disease, often have varying degrees of decline in kidney function, metabolism and excretion of drugs have varying degrees of decline, easy to cause drug accumulation in the body, causing drug side effects greatly increased.
, on the other hand, the elderly have many diseases and medications, and for elderly patients with kidney disease, various drugs are more likely to cause damage to the kidneys.
the use of drugs for elderly kidney patients should be of more concern.
1, elderly kidney disease patients should pay attention to adjust the dose and usage of the study shows that after the age of 30, the rate of renal function, i.e. renal cystic filtration rate of about 1% per year, to 65 years of age or older, renal function may naturally decline by more than 30%.
of kidney disease patients will be more, coupled with the elderly liver metabolase function decline, drug concentration is easy to be high.
the drug, consider the dose of the drug according to its metabolic pathway.
the dose of antibiotics to adjust the resistance of the elderly, lung infections and urinary tract infections are common, is the use of antibiotics in large households.
commonly used cephalosporine and "sand star" antibiotics are excreted from the kidneys, elderly kidney disease patients should adjust the dose according to the rate of kidney filtration.
the general hospital examination room according to the patient's blood creatinine and age and gender, can easily calculate the rate of renal filtration.
if the rate of renal filtration is halved, the dose of antibiotics is halved or the interval between medications is doubled.
if kidney function is only one-third normal, the interval between medications is three times.
For people over 75 years of age, even if the blood creatinine is normal, it does not necessarily mean that kidney function has not decreased, but also appropriate reduction of antibiotic dose or halve, because the elderly muscle mass reduction, blood creatinine does not fully reflect kidney function.
the dose of immunosuppressants adjusted to elderly patients with kidney disease need immunosuppressant treatment, elderly patients would have decreased immunity, if immunosuppressants with conventional doses of treatment, their resistance will be more reduced, easy to infect.
, older people should consider dose reduction when using immunosuppressants.
If an elderly or elderly kidney patient is found to be prone to colds, pneumonia or urinary tract infections during normal treatment, it is necessary to adjust the dose of the patient's immunosuppressants.
commonly used immunosuppressants such as cyclosporine and tycophenol esters can measure the concentration of drugs, the concentration of drugs in the elderly should be adjusted to normal low.
if the concentration is not measured, it is reasonable for immunosuppressants to be halved in people over 75 years of age.
common drug-adjusted elderly patients with common geriatric diseases are hypertension, diabetes, hyperlipidemia and hyperuretic acid disease.
For geriatric kidney disease, commonly used antihypertensive drugs have "Lore" class, "ground level" class, "Puli" class and "shatan" class, that is, the drug name contains these two words, representing different drug effects.
the elderly in the use of "Lore" and "ground level" class, mainly according to blood pressure to adjust the dose.
the use of "puli" and "shatan" classes, there are different research recommendations because their effects affect the blood vessels of the kidneys.
it is generally believed that when kidney function is reduced by more than half, these two types of anti-blood pressure drugs should be used reasonably under the guidance of a specialist.
also pay attention to kidney function when using oral anti-sugar drugs for diabetics.
if there is renal insequestration, it is not appropriate to use metformin, as it may lead to lactic acidosis.
can choose Reglinay, which is not affected by kidney function.
specific to follow the doctor's instructions.
blood lipid-lowering drugs are mainly metabolized by the liver, renal insemination is not affected, uric acid-lowering drugs, because benzo bromine malone is to promote the excretion of uric acid kidneys, such as kidney damage may be detrimental to the kidneys.
so the kidney function is poor, you can choose to reduce uric acid production of drugs such as allopurinol or non-busta.
2, elderly kidney disease patients should pay attention to the drug caused by kidney damage aggravated kidney disease patients' kidneys are more vulnerable than adults, more vulnerable to damage, always pay attention to the treatment process of elderly kidney disease patients kidney damage aggravated situation, especially the damage to the kidneys of various drugs.
when blood creatinine rises rapidly in a short period of time, be careful that the drug causes acute kidney damage.
attention to the damage of antibiotics to renal tubes in the elderly lung infections are often treated with antibiotics, in elderly patients with kidney disease, the larger damage to the kidneys of a class of drugs is prohibited, such as Gyeantamycin and tobumycin.
also need to pay attention to antibiotic dose should not be too large, continuous medication time should not be too long.
especially some chronic inflammation, need a long course of treatment, pay attention to the selection of several effective drugs to take turns to use, can avoid the same drug long-term use of kidney damage.
also pay attention to dose adjustment when the above kidney function is not complete.
attention to the effects of nephrotic damage is common in older people with cardiovascular disease, cerebrovascular disease and tumors.
cardiovascular disease may require angiocephaly and stent therapy.
patients with cancer may need CT-enhanced anthosmology and other tests.
can cause kidney damage, especially in the elderly and those with kidney disease.
the consequences of contrast agent and the necessity of comparing contrast agent use according to the patient's renal function.
the use of a small effect on the kidneys to control the dose of the effect of the formant.
attention to rehabilitation after kidney damage.
attention to the increased risk of cancer in older people with kidney damage from chemotherapy drugs, which are the most common treatment.
the damage to the kidneys from chemotherapy is certain, especially in the elderly with kidney disease.
but chemotherapy is also necessary, so weigh the need for treatment against acceptability.
chemotherapy is life-saving, kidney damage is still there, so the necessary chemotherapy should be put first.
, of course, during the chemotherapy interval, can actively treat the kidney so that it can restore kidney function as much as possible.
often meet patients in the clinic after chemotherapy to the nephrology department for renal function recovery treatment, or before chemotherapy to treat renal insanity.
, the elderly need to pay attention to drug use, the use of kidney disease in old age more need to pay special attention.
therefore requires multidisciplinary cooperation in the process of chronic kidney disease in old age, especially with the participation of pharmacists.
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