Access the Medication Adherence in the Chronic Kidney Disease Patient While Using the Antihyperlipidemic Drugs: A Systemic Literature Review

Chronic Kidney Disease (CKD) is a progressive and long-term condition characterized by structural or functional kidney abnormalities persisting for at least three months, leading to gradual loss of renal function and increased risk of complications such as cardiovascular disease, anemia, and metabolic disorders. CKD is classified into five stages based on glomerular filtration rate (GFR), ranging from mild kidney damage to end-stage renal disease requiring dialysis or transplantation. Globally, CKD affects approximately 9–10% of the population and represents a significant public health burden, particularly in low- and middle-income countries where early detection and management remain limited. Among its complications, dyslipidemia plays a critical role in accelerating cardiovascular risk, making antihyperlipidemic therapy especially statins a cornerstone in CKD management. Medication adherence is a crucial factor in determining clinical outcomes in CKD patients, as the disease often requires long-term and complex pharmacotherapy. The Adherence to Refills and Medications Scale (ARMS) is a validated self-reported tool used to assess adherence, particularly in patients with low health literacy, by evaluating both medication-taking and prescription refill behaviors. However, adherence in CKD is frequently suboptimal due to factors such as polypharmacy, adverse drug effects, poor disease awareness, and socioeconomic barriers. Non-adherence is associated with faster disease progression, poor control of comorbidities, increased hospitalization, and higher mortality rates. Clinical pharmacists play a vital role through medication review, patient counseling, and continuous monitoring, contributing significantly to improved adherence and therapeutic outcomes. Overall, enhancing adherence particularly to antihyperlipidemic therapy is essential for reducing complications, slowing disease progression, and improving the quality of life in CKD patients.