Medication Prescribing Patterns for Chronic Kidney Diseases: Analysis of Drug-Dose Adjustments, Polypharmacy, and Drug Interactions

Ainur Assan, Zakira Kerimbayeva, Ikilas Suyndikovich Moldaliyev, Dmitriy Syssoyev, Ali Issayev, Aizat Seidakhmetova, Rita Assabayeva, Meruyert Madikenova, Dmitry Alekseevich Sychev, Abduzhappar Gaipov

Data confidence 85 high

How this score is calculated

It is built from checkable properties of the record itself: whether the article has a DOI, how many independent sources confirmed its data, whether the required fields are filled in, and how recent the latest confirmation is. Disagreement between sources and a missing identifier lower it. A value of 80 or above means the record was published without further checking; 60 to 79 means it is published at reduced confidence, with a manual check advisable. A record verified by an editor by hand is never pushed below 90 by a recalculation. This scores our data about the article, not the article itself.

Abstract

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 afected 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 signifcant risks. Cite this article as: Assan A, Kerimbayeva Z, Moldaliyev I, et al. Medication prescribing patterns for chronic kidney diseases: Analysis of drug-dose adjustments, polypharmacy, and drug interactions. Turk J Nephrol. 2024;33(4):324-332.