Potentially inappropriate medication in patients with chronic kidney disease and elderly patients

Lüthke, Nikolas; Scheuch, Matthias; Engeßer, Jonas; Rheinbaben, Sabrina von; Hoffmann, Richardt; Aymanns, Simone; Fiene, Beate; Endlich, Karlhans; Lendeckel, Uwe; Rettig, Rainer; Petsch, Thomas; Dabers, Thomas; Stracke, Sylvia

doi:10.5414/cn110808

Cited by 2 publications

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“…Studies have reported that pharmacists may play a critical role in managing concurrent DKD, because of their unique perspectives on medications prescribed across conditions and providing actionable medication-related recommendations ( Fazel et al, 2017 ; Zullig et al, 2020 ). A few studies have shown that the incidence of potentially inappropriate medication (PIM) is high in older patients with chronic kidney disease (CKD) ( Roux-Marson et al, 2020 ; Luthke et al, 2022 ; Pehlivanli et al, 2022 ; Sharma et al, 2022 ); one has reported that proton pump inhibitors (PPI) were the most common medications induced PIM ( Pehlivanli et al, 2022 ), while others revelled that polypharmacy and reduced estimated glomerular filtration rate (eGFR) were predictors for PIM in this population ( Luthke et al, 2022 ; Sharma et al, 2022 ). There are studies on PIM in older diabetic patients ( Oktora et al, 2021 ), but few studies have explored PIM in older diabetic nephropathy patients in China.…”

Section: Introductionmentioning

confidence: 99%

Potentially inappropriate medication among older patients with diabetic kidney disease

Wang

Zhu²,

Shan³

et al. 2023

Front. Pharmacol.

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Objective: Potentially inappropriate medications (PIM) contribute to poor outcomes in older patients, making it a widespread health problem. The study explored the occurrence and risk factors of PIM in older diabetic kidney disease (DKD) patients during hospitalization and investigated whether polypharmacy was associated with it.Methods: Retrospective analysis of the patients ≥ 65 years old diagnosed with DKD from July to December 2020; the PIM was evaluated according to the American Beers Criteria (2019). Factors with statistical significance in univariate analysis were included in Logistic multivariate analysis to explore the potential risk factors related to PIM.Results: Included 186 patients, 65.6% of patients had PIM, and 300 items were confirmed. The highest incidence of PIM was 41.7% for drugs that should be carefully used by the older, followed by 35.3% that should be avoided during hospitalization. The incidence of PIM related to diseases or symptoms, drug interactions to avoid, and drugs to avoid or reduce dose for renal insufficiency patients were 6.3%, 4.0% and 12.7%, respectively. The medications with a high incidence of PIM were diuretics (35.0%), benzodiazepines (10.7%) and peripheral ɑ1 blockers (8.7%). Compared with hospitalization, there were 26% of patients had increased PIM at discharge. Multivariate Logistic regression analysis showed that polypharmacy during hospitalization was an independent risk factor for PIM, OR = 4.471 (95% CI: 2.378, 8.406).Conclusion: The incidence of PIM in hospitalized older DKD patients is high; we should pay more attention to the problem of polypharmacy in these patients. Pharmacists identifying the subtypes and risk factors for PIM may facilitate risk reduction for older DKD patients.

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Section: Introductionmentioning

confidence: 99%

Potentially inappropriate medication among older patients with diabetic kidney disease

Wang

Zhu²,

Shan³

et al. 2023

Front. Pharmacol.

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Factors associated with potentially inappropriate prescribing in elderly patients with various degrees of chronic kidney disease

Nedin Rankovic,

Pejcic,

Krtinic

et al. 2024

Hemodialysis International

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IntroductionThis study aimed to compare the prevalence of potentially inappropriately prescribed drugs in hemodialysis patients and patients with chronic kidney disease who did not require renal replacement therapy, as well as to identify risk factors associated with potentially inappropriate prescribing.MethodsThe study was designed as a cross‐sectional study conducted at the Department of Nephrology, Clinical Center in Nis, Serbia. The patients were divided into two groups: (1) patients on hemodialysis treatment and (2) patients with various degrees of chronic kidney disease without renal replacement therapy. The presence or absence of potentially inappropriate prescribing was determined using the 2015 AGS Beers criteria.FindingsThe study included a total of 218 patients aged 65 years and over. The number of patients with potentially inappropriate prescribed drugs did not differ significantly (chi‐square = 0.000, p = 1.000) between patients on hemodialysis (27 of 83, i.e., 32.5%) and patients with various degrees of chronic kidney disease without renal replacement therapy (44 of 135, i.e., 32.6%). Factors associated with potentially inappropriate prescribing in hemodialysis patients were the number of drugs (hazard ratio [HR] = 1.919, 95% confidence interval [CI]: 1.325–2.780) and number of comorbidities (HR = 1.743, 95% CI: 1.109–2.740). The number of drugs (HR = 1.438, 95% CI: 1.191–1.736) was the only independent factor associated with increased risk of potentially inappropriate prescribing in patients without renal replacement therapy.DiscussionOur study showed that potentially inappropriate prescribing is a relatively frequent phenomenon present in about a third of patients in both study groups. The number of prescribed drugs was the main factor associated with the increased risk of potentially inappropriate prescribing in both groups.

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Potentially inappropriate medication in patients with chronic kidney disease and elderly patients

Cited by 2 publications

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Potentially inappropriate medication among older patients with diabetic kidney disease

Potentially inappropriate medication among older patients with diabetic kidney disease

Factors associated with potentially inappropriate prescribing in elderly patients with various degrees of chronic kidney disease

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