Medication Prescribing Patterns for Chronic Kidney Diseases: Analysis of Drug-Dose Adjustments, Polypharmacy, and Drug Interactions
Assan A. Kerimbayeva Z. Moldaliyev I. Syssoyev D. Issayev A. Seidakhmetova A. Assabayeva R. Madikenova M. Sychev D. Gaipov A.
October 2024Turkish Society of Nephrology
Turkish Journal of Nephrology
2024#33Issue 4324 - 332 pp.
Background: Multiple drug prescriptions in chronic kidney disease (CKD) escalate metabolic buildup, nephrotoxicity, and end stage kidney disease progression. We aimed to study polypharmacy and harmful multi-drug interactions at the nephrology department of South-Kazakhstan Regional hospital. Methods: We analyzed electronic medical records of 485 patients with glomerular diseases (ICD-10 codes: N00-N08) admitted to the nephrology department from January 2018 to December 2021. We evaluated polypharmacy risk, dividing patients into low-risk, moderate-risk, and severe-risk groups based on the number of prescribed medications: 2-5, 6-9, and 10 or more, respectively. Additionally, we examined the occurrence and combinations of unsafe multi-drug interactions. Results: The study group included 45% CKD stage-1, 29% CKD stage-2, and 26% CKD stage-3 and above patients, with a median medication count of 9.5. Low-risk, moderate-risk, and severe-risk polypharmacy affected 12.2%, 48.2%, and 39.6% of patients, respectively. Inappropriate multi-drug combinations were particularly prevalent in early CKD stages. Notably, among commonly prescribed drugs, 19 out of 23 lacked dose adjustments according to the CKD stage. Conclusion: This pioneering study investigates polypharmacy and multi-drug interactions in CKD patients in Kazakhstan, revealing significant risks.
Chronic kidney disease , dose adjustment , drug interactions , nephrotoxicity , polypharmacy
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Department of Medicine, Khoja Akhmet Yassawi International Kazakh-Turkish University, Turkestan, Kazakhstan
Department of Public Health and Management, Astana Medical University, Astana, Kazakhstan
Department of Medicine, Nazarbayev University School of Medicine, Astana, Kazakhstan
Department of Ophthalmology, Kazakh National Research Institute of Eye Disease, Astana, Kazakhstan
Department of Emergency Medical Care and Nursing, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
Department of Oncology, City Multidisciplinary Hospital with Oncology Center, Shymkent, Kazakhstan
Department of Clinical Pharmacology and Therapy, Russian Medical Academy of Continuous Professional Education, Moscow, Russian Federation
Department of Medicine
Department of Public Health and Management
Department of Medicine
Department of Ophthalmology
Department of Emergency Medical Care and Nursing
Department of Oncology
Department of Clinical Pharmacology and Therapy
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