腎機能に関わる臨床検査データを活用した歯科外来処方における 医薬品適正使用推進に関する予備的研究.

In this study, we retrospectively investigated patients aged 18 years or older who received outpatient prescriptions in Department of Dentistry of Health Sciences University of Hokkaido Hospital based on laboratory data related to renal function from the Department of Internal Medicine. A total of 768 patients received outpatient prescriptions in the Department of Dentistry, of which 114 patients had a history of medical examination. In addition, laboratory data related to renal function from the Department of Internal Medicine was available for 71 patients, accounting for 9.2％ of the total. Six of 71 patients （8.5％） had serum creatinine levels above the reference value, which were evaluated as decreased renal function. Eighteen out of 71 patients（ 25.4％） showed a eGFR value of 59 mL/min/1.73 m² or less, which is one of the indicators for a diagnosis of CKD. All 18 patients were over 60 years old, and it was considered important to design the dental prescriptions in consideration of the deterioration of renal function due to aging. Of the 71 patients with renal function laboratory data, 18 patients with CKD stage G3a （mild to moderately decreased） to G4 （highly decreased） were investigated for dental prescription medicines. Three analgesics and 2 antibiotics were prescribed with the necessary precautions, such as dosage adjustment, as described in Clinical Practice Guideline for Drug-induced Kidney Injury in 2016. These analgesics and antibiotics were prescribed to 12 out of 18 patients, two of whom had CKD stage G3b disease（ moderately to highly decreased kidney function）, and considerations such as dose adjustments were necessary in terms of their prescriptions. As a result of this study, the necessity for prescription design based on laboratory data for renal function was again demonstrated in relation to dental prescriptions. Furthermore, it was suggested that by utilizing laboratory data from departments of internal medicine, it is possible to use medicines properly without burdening patients with the need for blood sampling [ABSTRACT FROM AUTHOR]