Clinical characteristics, medication use, and mortality outcomes in pediatric chronic kidney disease: A retrospective study at national hospital in Jakarta

Chronic kidney disease (CKD) in children necessitates the use of a variety of drugs to reduce disease progression and manage complications. Polypharmacy is common in children with CKD, which can increase the occurrence of harmful drug interactions. This study aimed to evaluate drug prescribing patterns and their association with mortality in pediatric CKD patients at X Hospital Jakarta, using disease stage as a critical variable. This retrospective observational study examined 124 children with CKD from January 2020 to December 2024. The correlation among mortality, polypharmacy, and CKD stage was assessed by bivariate analysis (Spearman test). Lexicomp and Stockley’s Drug Interactions analyzed drug interactions. Survival analysis was performed using Kaplan–Meier curves and Cox regression. The study results showed that the population was predominantly male (52.4%) and aged 13–16 years (33.06%), with 70.16% of patients having CKD Stage G5. Prescribed drugs included antihypertensives, antibiotics, anemia treatments, and immunosuppressants. The majority of medication interactions (89.4%) were classified as moderate in severity. Although polypharmacy was highest in Stage G5, the correlation test revealed no significant relationship between CKD stage and polypharmacy (Spearman’s coefficient, 0.105; P = 0.247). There were 14 deaths in total, with 10 of them occurring in Stage G5. However, survival analysis (log-rank P = 0.987; Cox regression P = 0.988) demonstrated no statistically significant difference in mortality risk among the CKD stages. This study highlights that, despite a greater number of fatalities in Stage G5, the survival models did not show a statistically significant relationship between CKD stage and mortality, nor between CKD stage and polypharmacy.