Polypharmacy and Dose Adjustment in Chronic Kidney Disease: A Cross-Sectional Study

TL;DR

This study examines medication use and dose adjustments in patients with chronic kidney disease across different stages.

Contribution

The study provides insights into polypharmacy and dose adaptation practices in CKD patients following the 2024 KDIGO guidelines.

Findings

Polypharmacy is common in all CKD stages, with an average of 11.2 medications per patient.

40.19% of patients required dose adjustments due to reduced kidney function.

Physicians appropriately adjusted an average of 4.6 medications per patient needing dose reduction.

Abstract

Chronic kidney disease (CKD) is a significant global health issue, primarily due to the rise in diabetes mellitus. This study aims to analyze the medications used in CKD patients with varying severity, focusing on dose adaptation.

This was a retrospective observational analysis of patients with CKD from various causes. CKD staging followed the 2024 Kidney Disease: Improving Global Outcomes (KDIGO) guidelines, and all medications given during the study were recorded, including documentation of dose adjustments due to reduced kidney function.

The study included 106 CKD patients. A total of 209 active medications were examined, with an average of 11.2 ± 4.8 substances used per patient. The average number of medications did not differ significantly across CKD stages. Dose adjustments for reduced kidney function were required in 40.19% of patients, who received an average of 5.4 ± 4.6 medications requiring dose reduction, with appropriate adjustments made for 4.6 ± 2.2 substances on average.

The study found that polypharmacy is present in all stages of CKD, and the significant rate of dose adjustments suggests that physicians are aware of the need to manage medications for CKD patients.