Key result
Diabetes mellitus was significantly associated with the initiation of polypharmacy in patients with chronic kidney disease (OR 2.46; 95% CI 1.36-4.45; P=0.003).
Why the study?
Patients with CKD bear a substantial burden of comorbidities leading to multiple drug prescriptions and polypharmacy, but data on medication use in this population are scarce.
Cohort
Odds Ratio: 2.46 (95% CI 1.36–4.45)
p-value: p=0.003
Patients with chronic kidney disease face a high burden of polypharmacy, with nearly 80% taking five or more medications daily, highlighting the need for strategies to manage drug interactions and reduce risks.
May warrant closer polypharmacy monitoring in diabetic CKD; observational data leaves open causal confirmation and intervention trials.
BACKGROUND: Patients with chronic kidney disease (CKD) bear a substantial burden of comorbidities leading to the prescription of multiple drugs and a risk of polypharmacy. However, data on medication use in this population are scarce. METHODS: and overt proteinuria (>500 mg/day) were studied. Self-reported data on current medication use were assessed at baseline (2010-12) and after 4 years of follow-up (FU). Prevalence and risk factors associated with polypharmacy (defined as the regular use of five or more drugs per day) as well as initiation or termination of polypharmacy were evaluated using multivariable logistic regression. RESULTS: The prevalence of polypharmacy at baseline and FU was almost 80%, ranging from 62% in patients with CKD Stage G1 to 86% in those with CKD Stage G3b. The median number of different medications taken per day was eight (range 0-27). β-blockers, angiotensin-converting enzyme inhibitors and statins were most frequently used. Increasing CKD G stage, age and body mass index, diabetes mellitus, cardiovascular disease and a history of smoking were significantly associated with both the prevalence of polypharmacy and its maintenance during FU. Diabetes mellitus was also significantly associated with the initiation of polypharmacy [odds ratio (OR) 2.46, (95% confidence interval 1.36-4.45); P = 0.003]. CONCLUSION: Medication burden in CKD patients is high. Further research appears warranted to address the implications of polypharmacy, risks of drug interactions and strategies for risk reduction in this vulnerable patient population.
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Schmidt et al. (2019) conducted a cohort in Chronic kidney disease (CKD). Diabetes mellitus was evaluated on Initiation of polypharmacy (OR 2.46, 95% CI 1.36-4.45, p=0.003). Diabetes mellitus was significantly associated with the initiation of polypharmacy in patients with chronic kidney disease (OR 2.46; 95% CI 1.36-4.45; P=0.003).
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