Brief research proposal Essay Example

Medication-related issues in patients with kidney disease

Rationale

Renal therapists have a big role to play in offering good management for patients with kidney disease, who are either treated in outpatient clinics or are confined to the hospital wards. By way of treating renal disease, therapists very often deliver antibiotics via the peritoneal route to treat peritonitis – a major complication of peritoneal dialysis (PD). This is accounted for by the fact that this ascertains the maximal concentrations of delivering the antibiotics at the site of infection. The problem with this mode of medication is that antibiotics that are administered through the peritoneal route may actually be absorbed into the systemic circulation of the patient. And, when kidney-excreted drugs accumulate in the biological system of the peritoneal dialysis patients, the risk of toxicity inevitably increases (Ranganathan et al., 2009).

Indeed, as established in many studies typified by the research of Manley et al. (2005), medication-related problems are common in hemodialysis patients. These medication-related problems may be categorized into nine (9) groups. These are the following: indication without drug therapy; drug without indication; improper drug selection; sub-therapeutic dosage; over-dosage; adverse drug reaction; drug interaction; failure to receive drug; and, inappropriate laboratory monitoring (Manley et al, 2005).

Renal failure is considered a common disease among the people of the Kingdom of Saudi Arabia (KSA). Statistics has it that eighty (80) to one hundred twenty (120) per one million of Saudi Arabians actually have this disease. Enormous is this disease’s economic burden on KSA, with an estimated cost per annum of maintenance hemodialysis in the amount of nineteen thousand four hundred dollars (USD19,400.00) in 2005. In fact, this large amount may very probably be more than the monetary capacity of many countries in the Arab region on account of their limited financial resources (Shaheen & Al-Khader, 2005).

On this account, there is a need for clinical researches that first of all requires qualified researchers. These will expectedly lead to establishment of a massive prevention program – the strategy of which will be innovative, imaginative and maximally cost effective. For, not only will reduction in medication-related problems in dialysis patients have benefits for the macro level of the KSA. Even among individuals, it translates to improvement of quality of life as well as decrease of morbidity and mortality.

Objectives

In corollary to the study by Ranganathan et al. (2009), which tried to examine a model of gentamicin pharmacokinetics and attempted to develop an intraperitoneal drug dosing regime maximizing bacterial killing and at the same time minimizing toxicity, this proposal envisions to delve into the two-fold aims of developing stability-indicating assays for some antibiotics (e.g. cephalosporins) as well as studying stability with storage in PD fluids, and developing assays to measure serum levels of the same drugs and looking at pharmacokinetics and modelling with PD delivery.

In specific terms, this proposal for study will dwell on the following:

  1. Pharmacokinetic / pharmacodynamics of medications that alter the renal function

  2. Medication-related problems among renal disease patients

  3. Drug-dosing studies in dialysis patients

  4. Clinical pharmacokinetics and clinical pharmacodynamics of immunosuppressant medications in renal transplantation patients

This study will be effective especially in areas of the management of anaemia in chronic renal failure, dosage adjustment in renal failure, management of acid-base disorders and minimization of side effects of medications in patients with renal failure.

References:

Manley, H et al., 2005, ‘Medication-related problems in ambulatory hemodialysis patients: a pooled analysis,’ American Journal of Kidney Disease, vol. 46, nol. 4, pp. 669-680.

Ranganathan, D et al. 2009, ‘Optimizing intraperitoneal gentamicin dosing in peritoneal dialysis patients with peritonitis (GIPD) study,’ BioMed Central Nephology, vol. 10, no. 42, pp. 1-6.

Shaheen, F & Al-Khader, A, 2005, ‘Preventive strategies of renal failure in the Arab world,’ Kidney International, vol. 68, pp. 37-40.