{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T15:28:37Z","timestamp":1788881317430,"version":"build-2803163510"},"reference-count":46,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T00:00:00Z","timestamp":1760400000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>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\u2009kg\/m<jats:sup>2<\/jats:sup>, 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\u00ae 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\u2009\u00b1\u20099.3 years; 49.9% female), 455 had an eGFR\u2009&gt;\u200960\u2009ml\/min\/1.73 m<jats:sup>2<\/jats:sup>, 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.<\/jats:p>","DOI":"10.1371\/journal.pone.0333345","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T17:22:16Z","timestamp":1760462536000},"page":"e0333345","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Detection of nephrotoxic drugs and dose adjustment in patients with low glomerular filtration rate in community pharmacy: A multicenter study in Spanish community pharmacies"],"prefix":"10.1371","volume":"20","author":[{"given":"Gema","family":"Escrib\u00e1-Mart\u00ed","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4292-2236","authenticated-orcid":true,"given":"Iker","family":"C\u00e1mara-Ramos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5976-8792","authenticated-orcid":true,"given":"Mar\u00eda Teresa","family":"Climent-Catal\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ver\u00f3nica","family":"Escudero-Quesada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9142-0569","authenticated-orcid":true,"given":"Luis","family":"Salar-Ib\u00e1\u00f1ez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,10,14]]},"reference":[{"key":"pone.0333345.ref001","article-title":"KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease","volume":"102","author":"Kidney Disease: Improving Global Outcomes (KDIGO) Diabetes Work Group","year":"2022","journal-title":"Kidney Int"},{"issue":"6","key":"pone.0333345.ref002","doi-asserted-by":"crossref","first-page":"414","DOI":"10.2471\/BLT.17.206441","article-title":"The global burden of kidney disease and the sustainable development goals","volume":"96","author":"VA Luyckx","year":"2018","journal-title":"Bull World Health Organ"},{"issue":"1","key":"pone.0333345.ref003","first-page":"1","article-title":"KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease","volume":"3","author":"Kidney Disease: Improving Global Outcomes (KDIGO) Chronic Kidney Disease Work Group","year":"2013","journal-title":"Kidney Int Suppl"},{"issue":"7","key":"pone.0333345.ref004","article-title":"Global prevalence of chronic kidney disease - a systematic review and meta-analysis","volume":"11","author":"NR Hill","year":"2016","journal-title":"PLoS One"},{"issue":"6","key":"pone.0333345.ref005","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1016\/j.nefroe.2018.04.010","article-title":"Chronic kidney disease in Spain: prevalence and impact of accumulation of cardiovascular risk factors","volume":"38","author":"M Gorostidi","year":"2018","journal-title":"Nefrologia (Engl Ed)"},{"issue":"9","key":"pone.0333345.ref006","doi-asserted-by":"crossref","first-page":"1384","DOI":"10.3390\/jcm8091384","article-title":"Prevalence of early chronic kidney disease and main associated factors in Spanish population: populational study","volume":"8","author":"C Exp\u00f3sito","year":"2019","journal-title":"J Clin Med"},{"issue":"12","key":"pone.0333345.ref007","doi-asserted-by":"crossref","first-page":"2155","DOI":"10.1038\/sj.ki.5000270","article-title":"Progression of kidney dysfunction in the community-dwelling elderly","volume":"69","author":"BR Hemmelgarn","year":"2006","journal-title":"Kidney Int"},{"key":"pone.0333345.ref008","volume-title":"CKD risk factors and prevention [Internet]","author":"Centers for Disease Control and Prevention (CDC)"},{"issue":"8","key":"pone.0333345.ref009","doi-asserted-by":"crossref","first-page":"1765","DOI":"10.1161\/HYPERTENSIONAHA.121.18881","article-title":"Effects of blood pressure according to age on end-stage renal disease development in patients with diabetes: a nationwide population-based cohort study","volume":"79","author":"EH Bae","year":"2022","journal-title":"Hypertension"},{"issue":"5","key":"pone.0333345.ref010","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1016\/j.pcd.2024.06.006","article-title":"Prevalence and characteristics of chronic kidney disease in people with type 2 diabetes mellitus in the Autonomous Community of Aragon","volume":"18","author":"MA S\u00e1nchez-Calavera","year":"2024","journal-title":"Prim Care Diabetes"},{"key":"pone.0333345.ref011","volume-title":"The number of kidney patients is growing among those over 60 years of age with diabetes and hypertension [Internet]","author":"Pan American Health Organization (PAHO)","year":"2014"},{"key":"pone.0333345.ref012","unstructured":"National Transplant Organization [Internet]. The National Transplant Organization presents its 2024 activity report. [cited 2025 Feb 26]. Available from: https:\/\/www.ont.es\/wp-content\/uploads\/2025\/01\/BALANCE-ONT-2024-PRENSA-completo-1.pdf"},{"issue":"1","key":"pone.0333345.ref013","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.kint.2020.10.012","article-title":"The case for early identification and intervention of chronic kidney disease: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference","volume":"99","author":"MG Shlipak","year":"2021","journal-title":"Kidney Int"},{"issue":"3","key":"pone.0333345.ref014","first-page":"273","article-title":"SEN-SEMFYC consensus document on chronic kidney disease","volume":"28","author":"R Alc\u00e1zar","year":"2008","journal-title":"Nefrologia"},{"issue":"3","key":"pone.0333345.ref015","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.nefroe.2022.07.003","article-title":"Information and consensus document for the detection and management of chronic kidney disease","volume":"42","author":"R Garc\u00eda-Maset","year":"2022","journal-title":"Nefrologia (Engl Ed)"},{"issue":"12","key":"pone.0333345.ref016","doi-asserted-by":"crossref","first-page":"2811","DOI":"10.1111\/bcp.13738","article-title":"Evaluation of the adequacy of drug prescriptions in patients with chronic kidney disease: results from the CKD-REIN cohort","volume":"84","author":"SM Laville","year":"2018","journal-title":"Br J Clin Pharmacol"},{"issue":"1","key":"pone.0333345.ref017","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1186\/s12877-019-1075-5","article-title":"Use of renal risk drugs in a nation-wide Polish older adult population: an analysis of PolSenior database","volume":"19","author":"E Deskur-\u015amielecka","year":"2019","journal-title":"BMC Geriatr"},{"issue":"1","key":"pone.0333345.ref018","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1177\/1715163515618421","article-title":"Community pharmacist targeted screening for chronic kidney disease","volume":"149","author":"YN Al Hamarneh","year":"2016","journal-title":"Can Pharm J (Ott)"},{"issue":"1","key":"pone.0333345.ref019","doi-asserted-by":"crossref","first-page":"7284","DOI":"10.1038\/s41598-024-56765-0","article-title":"Community pharmacist-led point-of-care eGFR screening: early detection of chronic kidney disease in high-risk patients","volume":"14","author":"AA Jairoun","year":"2024","journal-title":"Sci Rep"},{"issue":"6","key":"pone.0333345.ref020","doi-asserted-by":"crossref","first-page":"369","DOI":"10.4212\/cjhp.v66i6.1302","article-title":"Standards of clinical practice for renal pharmacists","volume":"66","author":"CB Raymond","year":"2013","journal-title":"Can J Hosp Pharm"},{"issue":"6","key":"pone.0333345.ref021","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1097\/MNH.0b013e328365b364","article-title":"New models of chronic kidney disease care including pharmacists: improving medication reconciliation and medication management","volume":"22","author":"WL St Peter","year":"2013","journal-title":"Curr Opin Nephrol Hypertens"},{"issue":"1","key":"pone.0333345.ref022","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1007\/s40258-018-0426-2","article-title":"Budget Impact Analysis of a Renal Point-of-Care Test in Dutch Community Pharmacies to Prevent Antibiotic-Related Hospitalizations","volume":"17","author":"JJ Gout-Zwart","year":"2019","journal-title":"Appl Health Econ Health Policy"},{"issue":"4","key":"pone.0333345.ref023","doi-asserted-by":"crossref","first-page":"5","DOI":"10.5672\/FC.2173-9218.(2019\/Vol11).004.02","article-title":"Determinaci\u00f3n de pulso irregular en farmacias comunitarias espa\u00f1olas. \u201cResultados del proyecto \u2018Know your pulse\u2019 2016 y 2017\u201d","volume":"11","author":"I Mera Gallego","year":"2019","journal-title":"FC"},{"key":"pone.0333345.ref024","article-title":"CRIDECO: a project to create neuroprotected cities","volume":"11","author":"H Ramos","year":"2019","journal-title":"Farmac\u00e9uticos Comunitarios"},{"issue":"5","key":"pone.0333345.ref025","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1177\/1715163515597243","article-title":"Online clinical pathway for managing adults with chronic kidney disease","volume":"148","author":"C Curtis","year":"2015","journal-title":"Can Pharm J (Ott)"},{"key":"pone.0333345.ref026","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1186\/1471-2296-14-96","article-title":"Effectiveness of a drug dosing service provided by community pharmacists in polymedicated elderly patients with renal impairment--a comparative study","volume":"14","author":"MA Via-Sosa","year":"2013","journal-title":"BMC Fam Pract"},{"key":"pone.0333345.ref027","first-page":"14","article-title":"Validation of the Nova StatSensor Xpress\u00ae blood creatinine meter in a community pharmacy","volume":"12","author":"J Espejo","year":"2020","journal-title":"Community Pharmacists"},{"key":"pone.0333345.ref028","unstructured":"CheckTheMeds\u00ae [Internet]. [Cited 26 May 2022]. Available from: www.checkthemeds.com"},{"key":"pone.0333345.ref029","author":"M Marc"},{"key":"pone.0333345.ref030","unstructured":"International Council for Harmonisation. ICH Harmonised Guideline: Integrated Addendum to ICH E6(R1): Guideline for Good Clinical Practice E6(R2) [Internet]. London: European Medicines Agency; 2016 [cited 2025 Jul 7]. Available from: https:\/\/www.ema.europa.eu\/en\/documents\/scientific-guideline\/ich-guideline-good-clinical-practice-e6r2-step-5-revision-2_en.pdf"},{"key":"pone.0333345.ref031","doi-asserted-by":"crossref","DOI":"10.1177\/2054358120922617","article-title":"Community Pharmacy-Based eGFR Screening for Early Detection of CKD in High Risk Patients","volume":"7","author":"J Papastergiou","year":"2020","journal-title":"Can J Kidney Health Dis"},{"issue":"2","key":"pone.0333345.ref032","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1177\/1715163520902495","article-title":"Community pharmacist identification of chronic kidney disease using point-of-care technology: A pilot study","volume":"153","author":"J Donovan","year":"2020","journal-title":"Can Pharm J (Ott)"},{"issue":"2","key":"pone.0333345.ref033","first-page":"5","article-title":"Screening for chronic kidney disease in the community pharmacy. CRIERFAC study: description of the methodology","volume":"16","author":"L Salar Ib\u00e1\u00f1ez","year":"2024","journal-title":"Farm Comunitarios"},{"issue":"2","key":"pone.0333345.ref034","first-page":"172","article-title":"Glomerular filtration rate estimation in people older than 85: Comparison between CKD-EPI, MDRD-IDMS and BIS1 equations","volume":"37","author":"F Bustos-Guada\u00f1o","year":"2017","journal-title":"Nefrologia"},{"issue":"708","key":"pone.0333345.ref035","doi-asserted-by":"crossref","DOI":"10.3399\/BJGP.2020.0871","article-title":"Potentially inappropriate primary care prescribing in people with chronic kidney disease: a cross-sectional analysis of a large population cohort","volume":"71","author":"C MacRae","year":"2020","journal-title":"Br J Gen Pract"},{"issue":"3","key":"pone.0333345.ref036","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1111\/bcpt.13127","article-title":"Prevalence of renally inappropriate medicines in older people with renal impairment - A cross-sectional register-based study in a large primary care population","volume":"124","author":"K Schmidt-Mende","year":"2019","journal-title":"Basic Clin Pharmacol Toxicol"},{"issue":"5","key":"pone.0333345.ref037","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1093\/fampra\/cmy001","article-title":"Prescription of high-risk medications among patients with chronic kidney disease: a cross-sectional study from the Washington, Wyoming, Alaska, Montana and Idaho region Practice and Research Network","volume":"35","author":"J Guirguis-Blake","year":"2018","journal-title":"Fam Pract"},{"issue":"670","key":"pone.0333345.ref038","doi-asserted-by":"crossref","DOI":"10.3399\/bjgp18X695993","article-title":"Application of prescribing recommendations in older people with reduced kidney function: a cross-sectional study in general practice","volume":"68","author":"S Wood","year":"2018","journal-title":"Br J Gen Pract"},{"issue":"7","key":"pone.0333345.ref039","doi-asserted-by":"crossref","DOI":"10.1111\/ijcp.12960","article-title":"Inappropriate prescribing in chronic kidney disease: A systematic review of prevalence, associated clinical outcomes and impact of interventions","volume":"71","author":"WH Tesfaye","year":"2017","journal-title":"Int J Clin Pract"},{"issue":"11","key":"pone.0333345.ref040","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1007\/s40266-014-0208-y","article-title":"Impact of the pharmacist medication review services on drug-related problems and potentially inappropriate prescribing of renally cleared medications in residents of aged care facilities","volume":"31","author":"PA Gheewala","year":"2014","journal-title":"Drugs Aging"},{"issue":"12","key":"pone.0333345.ref041","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2023-079110","article-title":"Impact of a pharmacy-led screening and intervention in people at risk of or living with chronic kidney disease in a primary care setting: a cluster randomised trial protocol","volume":"13","author":"W Tesfaye","year":"2023","journal-title":"BMJ Open"},{"issue":"2","key":"pone.0333345.ref042","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1007\/s11096-018-0603-2","article-title":"Patient satisfaction with a chronic kidney disease risk assessment service in community pharmacies","volume":"40","author":"PA Gheewala","year":"2018","journal-title":"Int J Clin Pharm"},{"issue":"4","key":"pone.0333345.ref043","doi-asserted-by":"crossref","first-page":"352","DOI":"10.3109\/13561820.2014.898621","article-title":"Perceptions of collaboration between general practitioners and community pharmacists: findings from a qualitative study based in Spain","volume":"28","author":"AM Jov\u00e9","year":"2014","journal-title":"J Interprof Care"},{"key":"pone.0333345.ref044","unstructured":"SEMERGEN; SEFAC. Zaragoza Manifesto. Protocolization of communication between family doctors and community pharmacists. 5th National Medical-Pharmaceutical Congress SEMERGEN-SEFAC, Zaragoza; June 23\u201324, 2023. Nov 21, 2023. Available from: https:\/\/www.sefac.org\/notas-de-prensa\/presentado-el-manifiesto-de-zaragoza-que-busca-protocolizar-la-comunicacion-entre"},{"key":"pone.0333345.ref045","volume-title":"Classification of pharmacotherapeutic referrals","author":"R Pastor S\u00e1nchez","year":"2008"},{"key":"pone.0333345.ref046","article-title":"KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease","volume":"105","author":"Kidney Disease: Improving Global Outcomes (KDIGO)","year":"2024","journal-title":"Kidney Int"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0333345","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T17:22:23Z","timestamp":1760462543000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0333345"}},"subtitle":[],"editor":[{"given":"Anukul","family":"Ghimire","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,10,14]]},"references-count":46,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10,14]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0333345","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,14]]}}}