Utilization Of Nephrotoxic Drugs In Post-Operative Patients Of Urolithiasis

Background of Study: Renal ( or kidney) stones have been around for centuries. Egyptian mummies have been found to contain stones. Around the 5th century B. C., physicians at a medical school in Asia Minor described renal colic or pain in detail. Much information has been gathered about the condition in recent years, but more is to be learned about the cause and treatment. Urolithiasis is quite common in developing countries, especially in Nepal. This problem is particularly important in the Nepalese context, perhaps because of the climate, terrain, the living condition of the people and economic aspects. A large number of drugs are also responsible for causing urolithiasis or kidney damage. Aim of Study: To screen the cases of urolithiasis which were operated in the past two years, and to find and establish whether nephrotoxic drugs were used in the treatment. Materials and Methods: This is a retrospective study of hospital records of over two years, from January 2001-December 2002. 193 cases were operated for urolithiasis, which were the targeted cases of this retrospective study, and a prescription audit was done on the post operative prescriptions and follow up treatment given by surgeons at Nepal Medical College Teaching Hospital (NMCTH), a major teaching hospital of Katmandu valley, with a view to observe whether nephrotoxic drugs were prescribed for urolithiasis, and a suggestion for avoiding their use so that the reoccurrence of disease is prevented. Results: A majority of subjects (57.51%) had urolithiasis from the productive age group. Four cases of renal damage were observed among the urolithiasis subjects. 31.08% (60 out of 193) of the urolithiasis subjects were prescribed nephrotoxic drugs. Diclofenac sodium was given in 18.13% of the total subjects, including three subjects of renal damage even being given a potent nephrotoxic drug. Conclusion: Nephrotoxic drugs have to be avoided in pre-operative, post- operative, and follow up prescriptions in urolithiasis patients.