Drugs in the elderly with chronic kidney disease: beware of potentially inappropriate medications.

In the USA, ADRs result in over 700 000 visits to hospital emergency rooms and 120 000 hospitalizations each year [32]. Costs of ambulatory (non-hospital settings) ADR are also significant, and at least 40% of them may be preventable [33]. The seriousness of ADR-related public health problems led the Centers for Disease Control and Prevention to establish a medication safety programme (http://www.cdc.gov/medicationsafety/). In elderly dialysis patients, ADRs and the use of PIMs might be an even greater problem. In conclusion, we strongly support the notion that more studies are needed on the problem of PIMS in dialysis patients, especially in the elderly. As many adverse drug events can be prevented, it could be extremely useful to develop specific PIM criteria for dialysis patients, identifying those medications that could be withdrawn, thus reducing the pill burden and, at the same time, increasing the safety of our patients.