OBJECTIVE: This report is describing the development and implementation process of the knowledge-based renal dose adjustment system at a university hospital.

METHOD: From the hospital drug formulary which included about 1500 medications, clinical pharmacists selected 243 nephrotoxic medications which require dose adjustment in patients with renal impairment. Through literature review and consultation of clinical pharmacists, nephrologist, and infectious disease specialist, we developed an accordant renal dosing knowledge-base and used them to build the rules for dosage adjustment alerts and to provide information related to alerts such as patients' age, gender, most recent weight, latest serum creatinine, calculated creatinine clearance, and recommended dosage for renal insufficiency.

STATUS REPORT: As of August 2006, the renal dosing system which monitored drug prescription and generated real-time alerting window to help physician to adjust drug doses in patients with renal impairment was implemented and has been operated well since initial implementation.

CONCLUSION: Renal dosing system based upon knowledge-based renal dosing guideline was successfully developed and implemented into a local clinical practicesetting.