Mean GFR and standard deviation by age group.

Chronic kidney disease (CKD) represents a significant global health burden, with its prevalence markedly increasing in the elderly. This multicenter, non-controlled, prospective study was conducted in 16 Spanish community pharmacies to assess the feasibility of identifying potentially inappropriate prescriptions (PIPs) in patients with reduced estimated glomerular filtration rate (eGFR). Patients over 60 years old with a body mass index between 19 and 35 kg/m2, who were taking at least one nephrotoxic medication or a drug requiring dose adjustment based on renal function, were recruited. A point-of-care (POC) test for creatinine using the StatSensor Xpress® analyzer was performed for those lacking an eGFR measurement in the previous three months, with eGFR calculated via the CKD-EPI formula. Of the 670 patients recruited (mean age 72.5 ± 9.3 years; 49.9% female), 455 had an eGFR > 60 ml/min/1.73 m2, while 215 had values below this threshold. The medication of these latter patients was reviewed, and in 90 of them (41.9%) a potentially inappropriate prescription was identified, leading to their referral to their primary care physician. Of the total sample, 13.4% of the patients had at least one PIP. Changes were requested for 9.0% of the medications, and these were implemented in 3.4%. The proportion of PIPs increased with CKD severity, with higher intervention rates observed in advanced stages. These findings highlight the potential of community pharmacies to contribute to early CKD risk detection and medication optimization, emphasizing the need for enhanced direct communication channels between pharmacists and physicians to improve patient outcomes.慢性肾脏病（CKD）是一项沉重的全球健康负担，其患病率在老年人群中显著上升。本项多中心、非对照、前瞻性研究于16家西班牙社区药房开展，旨在评估估算肾小球滤过率（eGFR）降低患者中识别潜在不适当处方（PIPs）的可行性。研究招募年龄≥60岁、体质量指数介于19~35 kg/m²，且服用至少一种肾毒性药物或需根据肾功能调整剂量的药物的患者。对于近3个月未进行eGFR检测的患者，采用StatSensor Xpress®分析仪开展肌酐床旁（POC）检测，并通过CKD-EPI公式计算eGFR。本研究共纳入670例患者（平均年龄72.5±9.3岁，女性占比49.9%），其中455例患者eGFR＞60 ml/min/1.73m²，剩余215例患者eGFR低于该阈值。研究人员对该215例eGFR降低的患者的用药情况进行审查，其中90例（41.9%）被检出存在潜在不适当处方，遂将其转诊至其初级保健医师。全部研究对象中，13.4%的患者存在至少一种潜在不适当处方。研究中9.0%的药物被建议调整，最终3.4%的调整方案得以实施。潜在不适当处方的比例随CKD严重程度升高而增加，晚期CKD患者的干预率也更高。本研究结果凸显了社区药房在早期CKD风险筛查与用药优化中的潜在价值，同时强调需加强药师与医师间的直接沟通渠道，以改善患者转归。