{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T06:29:41Z","timestamp":1786602581084,"version":"build-2736575974"},"reference-count":71,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Clin Pharmacol"],"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To quantify prescribing adherence to renal dosing recommendations in adults with chronic kidney disease (CKD; Stage 3 and above) and to evaluate the clinical consequences of non\u2010adherence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This systematic review and meta\u2010analysis was conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD42025620883). Eight electronic databases were searched from inception to 31 December 2025. Quantitative studies assessing renal dose adjustment practices in adults with advanced CKD were included in the review. Two reviewers independently performed study selection, data extraction and quality assessment. Random\u2010effects meta\u2010analyses (REML) were used to pool adherence proportions at prescription\/order and patient levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty studies were included in the review. The observational studies were of moderate to high quality, while the two interventional studies had moderate risk of bias due to confounding. Prescribing adherence to renal dosing guidelines ranged from 33% to 87.7%. Pooled prescription\/order\u2010level guideline adherence (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200916) was 0.48 (95% CI 0.42\u20130.55;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0\u2248\u200998%). Conversely, the pooled patient\u2010level guideline adherence (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20097) was higher at 0.7 (95% CI 0.57\u20130.83;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0\u2248\u200999.9%). The study results suggest that the prevalence of prescribing non\u2010adherence to renal dosing guidelines was high and may be associated with various adverse drug events.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The available evidence suggests that adherence to renal dosing recommendations in adults with advanced CKD is variable and may be suboptimal. The pooled estimate suggests a potential safety gap, although substantial heterogeneity limits interpretation. Furthermore, non\u2010adherence to renal dosing recommendations was associated with adverse clinical consequences and increased healthcare utilization. High\u2010quality studies are needed to inform effective strategies aimed at improving prescribing practices and medication safety.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bcp.70731","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T06:05:18Z","timestamp":1786601118000},"source":"Crossref","is-referenced-by-count":0,"title":["Current practice and guideline adherence in renal dose adjustment for patients with chronic kidney disease: A systematic review and meta\u2010analysis"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4187-9827","authenticated-orcid":false,"given":"Hager","family":"ElGeed","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health Sector Qatar University  Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5563-9204","authenticated-orcid":false,"given":"Ahmed","family":"Tehemar","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health Sector Qatar University  Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Gasimelseed","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health Sector Qatar University  Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1323-2053","authenticated-orcid":false,"given":"Ahmed","family":"Gharaibeh","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health Sector Qatar University  Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0108-7833","authenticated-orcid":false,"given":"Muhammad Abdul","family":"Hadi","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health Sector Qatar University  Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazeem","family":"Yusuff","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health Sector Qatar University  Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2859-1370","authenticated-orcid":false,"given":"Amani","family":"Zidan","sequence":"additional","affiliation":[{"name":"QU\u2010Health Sector Qatar University  Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9029-8925","authenticated-orcid":false,"given":"Ahmed","family":"Awaisu","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health Sector Qatar University  Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"1108","DOI":"10.1590\/1806-9282.64.12.1108","article-title":"Global costs attributed to chronic kidney disease: a systematic review","volume":"64","author":"Silva Junior GBD","year":"2018","journal-title":"Rev Assoc Med Bras"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.4158\/ep13269.or"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40256\u2010021\u201000473\u2010x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0897190019828270"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.3810\/pgm.2011.05.2291"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/875512251302900403"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsps.2023.03.008"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/0886022X.2024.2353341"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfab120"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcpt.13986"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532\u20105415.2008.02098.x"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00228\u2010004\u20100852\u2010y"},{"key":"e_1_2_10_14_1","unstructured":"De VriesT HenningRH HogerzeilHV FresleD Policy M. 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