Clinical Case Database / Category: Case Based Discussion

Prescribing in chronic kidney disease

Publication details

Dr Damien Ashby, MA, MRCP, Ms Rania Betmouni, MPharm, Prof Edwina Brown, DM, FRCP
Foundation Years Journal, volume 1, issue 4, p.181 (123Doc Education, London, July 2007)


Nursing staff ask you to review a 70-year-old woman on the ward who has developed melaena.She was admitted 3 days ago with chest pain, and treated with aspirin, clopidogrel and enoxaparin 45mg twice daily (1mg/kg). You notice that her admission creatinine was 140µmol/l, and wonder if dose adjustments need to be made at this level.

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Dr Damien Ashby, MA, MRCP (Corresponding author)

Clinical Research Fellow, Imperial College London
Department of Metabolic Medicine
6th flor, Commonwealth Building
Hammersmith Hospital
London, W12 0NN

Ms Rania Betmouni, MPharm

Lead Renal Pharmacist, Hammersmith Hospital

Prof Edwina Brown, DM, FRCP

Professor of Nephrology, Imperial College
Consultant Physician, Hammersmith Hospital


1.  Cockcroft DW, Gault MH: Prediction of creatinine clearance from serum creatinine. Nephron 1976;16:31-41.

2.  Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D: A more accurate method to estimate glomerular fitration rate from serum creatinine: a new prediction equation. Modifiation of Diet in Renal Disease Study Group. Ann Intern Med 1999;130:461-470.

3.  Ashley C, Currie A (eds): The renal drug handbook. 2nd ed. Radcliffe Medical Press Ltd, 2004


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T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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