Potential drug-drug interactions among patients with chronic kidney disease admitted at National Hospital: a retrospective study in Tanzania

2020 ◽  
Author(s):  
Wigilya Mikomangwa ◽  
Jephter E. Malifa ◽  
Hamu Mlyuka ◽  
Ritah Mutagonda ◽  
Manase Kilonzi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Drug Interactions ◽  
P Value ◽  
Potential Drug ◽  
National Hospital ◽  
Prescribed Medicines ◽  
Prolonged Hospital ◽  
Social Demographic

Abstract Background: Drug related problems such as drug-drug interactions (DDI) are likely to occur in chronic kidney disease (CKD) patients due to polypharmacy practice. The DDI increases the risk of morbidity, mortality, prolonged hospital and cost of treatment. In most cases, the potential drug-drug interactions (pDDI) are not checked during prescribing or dispensing of polypharmacy for CKD patients in developing countries like Tanzania. Therefore, we documented the pattern and potential drug-drug interactions (DDIs) among CKD patients admitted at Muhimbili National Hospital (MNH).Methods: The study retrospectively reviewed 198 files for CKD patients admitted at MNH between January 2017 and December 2018. The social-demographic characteristics and comorbidities were documented using a checklist. Prescriptions with polypharmacy were reviewed and prescribed medicines were documented. Medscape drug interaction checker was used for pDDIs. The SPSS version 23.0 was used to carry out statistical analysis. Results: The study involved a total of 306 prescriptions with polypharmacy with a mean(±SD) of 6.21(±1.22) medicines per prescription. Majority of patients (77.2%) were in stage 5 of chronic kidney disease. Frequently prescribed medicines were pantoprazole 135(44.1%), furosemide 133(43.5%), ferrotone 101(33.0%), calcium carbonate 91(29.7%), amlodipine 121(39.5%), nifedipine 83(27.1%), bisoprolol 46(15.0%) and clonidine 38(12.4). The prevalence of pDDIs was 94.1%. The total of 1743 potential drug-drug interactions was observed with a mean of 6.03(±2.12) interactions per prescription. Majority of the pDDIs were moderate (67.5%) whereas, 29.5%, 2.6% and 0.3 were minor, serious and contraindicated respectively. The occurrence of pDDIs was associated with stroke (P-value=0.038), diabetes mellitus (p-value=0.049) and hypertension with diabetes mellitus (p-value=0.047).Conclusion: The prevalence of pDDIs was high among the CKD patients. The determinants of pDDIs among CKD patients were hypertension, diabetes mellitus and stroke. Interaction checkers should be incorporated in health system to guide the prescribing and dispensing of medicine for CKD patients.

scholarly journals Prevalence of Potential Drug–Drug Interaction Risk among Chronic Kidney Disease Patients in a Spanish Hospital

Pharmaceutics ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 713
Author(s):  
Gracia Santos-Díaz ◽  
Ana María Pérez-Pico ◽  
Miguel Ángel Suárez-Santisteban ◽  
Vanesa García-Bernalt ◽  
Raquel Mayordomo ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Drug Interactions ◽  
Cross Sectional Study ◽  
Potential Drug ◽  
Cross Sectional ◽  
Major Health Problem ◽  
Major Health ◽  
Spanish Hospital

Chronic kidney disease (CKD) is a major health problem worldwide and, in Spain, it is present in 15.1% of individuals. CKD is frequently associated with some comorbidities and patients need to be prescribed multiple medications. Polypharmacy increases the risk of adverse drug reactions (ADRs). There are no published studies evaluating the prevalence of potential drug–drug interactions (pDDIs) among CKD patients in any European country. This study was aimed to determine the prevalence, pattern, and factors associated with pDDIs among CKD patients using a drug interactions program. An observational cross-sectional study was carried out at Plasencia Hospital, located in Spain. Data were collected among patients with CKD diagnoses and pDDIs were assessed by the Lexicomp® Drug Interactions platform. Data were obtained from 112 CKD patients. A total number of 957 prescribed medications were acknowledged, and 928 pDDIs were identified in 91% of patients. Age and concomitant drugs were significantly associated with the number of pDDIs (p < 0.05). According to the results, the use of programs for the determination of pDDIs (such as Lexicomp®) is recommended in the clinical practice of CKD patients in order to avoid serious adverse effects, as is paying attention to contraindicated drug combinations.

scholarly journals Effective monitoring of diabetic patients on progressive chronic kidney disease among patients attending diabetic clinic at Muhimbili National Hospital, Tanzania

2021 ◽  
Vol 1 (3) ◽  
pp. 044-052
Author(s):  
Gudila Valentine Shirima ◽  
Paschal Joseph Rugajjo ◽  
Obadia Venance Nyongole ◽  
Francis Furia ◽  
Kimu Marko Njiku
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Clinical Notes ◽  
Renal Functions ◽  
Diabetic Clinic

Background: Diabetic Kidney Disease is a complication of Diabetes Mellitus (DM) following the natural history of diabetes. Worldwide up to 40 % of patients with diabetes mellitus will develop Diabetic Kidney Disease. Kidney Disease Outcome Quality Initiative (KDOQI) guidelines recommends monitoring for proteinuria, blood sugar, renal functions and blood pressure in the patients with DM so that progression to complications including renal failure is prevented. Our study aimed to audit on effective monitoring of progressive chronic kidney disease among patients attending diabetic clinic at Muhimbili National Hospital. Material and methods: This was a retrospective clinical audit which included patients who attended diabetic clinic at Muhimbili National Hospital in 1st January 2017 to 31st December 2017. Simple random sampling technique using software called OpenEpi Random Program was used to get the sample of 120 patients. Patients with missing clinical notes were excluded from the audit. Records of the clinical notes, socio-demographic characteristics and investigations of the selected patients were retrieved from the Jeeva system and recorded using a structured questionnaire. We analyzed our data using Statistical Package for Social Sciences (SPSS) version 20.0 Results: One hundred and fourteen DM patents records were reviewed. Around 79% of the patients involved in the study were aged above 45years, 60% were females. Majority had type 2 DM (76.3%). Minority i.e. 15/114 (13.2%) of the patients had their urine for protein checked in the year 2017 as well as serum creatinine in the last 3months. Seven percent had HbA1c test done i.e. 8/114 (7%). Blood pressure was monitored in 72.8% (83/114) of the patients. Only16 out of 66 patients (24.2%) had blood pressure controlled. Majority of the patients 10/15 (66.7%) who had renal functions records had normal eGFR. Findings on monitoring for proteinuria, renal functions, control of HbA1c and Blood pressure control were all below audit standards. Conclusion: Our study found that there is generally poor monitoring of diabetic outpatient for progressive chronic kidney disease when compared to the KDOQI standards which calls the health care providers to adhere on set SOPs according to the guidelines available aiming at improving services and quality of life to diabetic patient.

Survival of Patients on Maintenance Hemodialysis Base on Comorbidity of Cardiovascular Disease in Persahabatan Central General Hospital 2015-2019

2021 ◽  
Vol 19 (2) ◽  
pp. 125-133
Author(s):  
Mila Fitriaty ◽  
Nurhayati Adnan ◽  
Muhammad Syafiq
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Internal Validity ◽  
Secondary Data ◽  
Maintenance Hemodialysis ◽  
P Value ◽  
Risk Of Death ◽  
Number Of Patients

Chronic kidney disease is the progressive loss of kidney function over months or years. The significant increase in new cases of chronic kidney disease is in line with the increasing number of patients undergoing hemodialysis as kidney replacement therapy in an effort to survive. Comorbid cardiovascular disease is a major risk factor for morbidity and mortality with chronic kidney disease. The study was conducted to determine the survival of hemodialysis patients in the group with comorbid cardiovascular disease and the group without comorbid cardiovascular disease. This study used a retrospective cohort design. The location of this study was conducted at Persahabatan Central Public Hospital, DKI Jakarta, and used secondary data from the hospital information system data from 2015 to 2019. The variables significantly related to the survival of patients undergoing hemodialysis with comorbid cardiovascular disease were age, complications of anemia, diabetes mellitus, and hypertension. The age variable has a p-value of 0.029 with an HR of 1.54 (95% CI OR 1.043-2.262). The anemia variable has a p-value of 0.013 with an HR of 1.60 (95% CI 1.117-2.515). The diabetes mellitus variable has a p-value of 0.000 with HR2.71 (95% CI 1.780-4.11). The hypertension variable has a p-value of 0.004 with HR1.79 (95% CI 1.208-2.646). In conclusion, patients undergoing hemodialysis with comorbid cardiovascular disease have a risk of death of 0.76 times compared to patients undergoing hemodialysis with the comorbid non-cardiovascular disease. This study's internal validity was not good due to selection bias and non-differential misclassification information bias. Thus, the results of this study cannot be generalized.

Prevalence and pattern of potential drug-drug interactions among chronic kidney disease patients in south-western Nigeria

2017 ◽  
Vol 24 (2) ◽  
pp. 88 ◽  
Author(s):  
AdejumoAdemola Oluseyi ◽  
JFasipe Olumuyiwa ◽  
AAkinbodewa Akinwumi ◽  
BAkawa Oluwole ◽  
EIbiene Okaka
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Drug Interactions ◽  
Potential Drug

scholarly journals Evaluation of potential drug–drug interactions among patients with chronic kidney disease in northeastern Nigeria

2019 ◽  
Vol 22 (1) ◽  
pp. 77-81
Author(s):  
Roland N. Okoro
Keyword(s):  
Chronic Kidney Disease ◽  
Calcium Carbonate ◽  
Kidney Disease ◽  
Drug Interactions ◽  
Ferrous Sulphate ◽  
Laboratory Data ◽  
Adverse Outcomes ◽  
Potential Drug ◽  
Cross Sectional ◽  
Increased Risk

Background: Potential drug–drug interactions (pDDIs) may not manifest clinically in patients who are treated with multiple pharmaceutical agents, but when they do they can produce adverse outcomes. In patients with chronic kidney disease (CKD), the frequent use of multiple agents to manage this condition and its complications puts these patients at increased risk for DDIs. We determined the prevalence of pDDIs in CKD patients in two Nigerian hospitals and investigated possible predictors of pDDIs. Methods: This cross-sectional study involved patients with CKD who attended the nephrology unit of the University of Maiduguri Teaching Hospital and the medical outpatients clinic of the State Specialist Hospital in Maiduguri, Nigeria. We collected prescriptions, clinical data and laboratory data from the medical files of patients seen between January 2013 and December 2017. Descriptive and inferential statistics were used to analyse the data. Results: The study included 201 patients. A total of 273 pDDIs were identified in 166 patients (83%). These pDDIs included 30 unique drug interactions, the most common being between ferrous sulphate and calcium carbonate (seen in 46% of patients with pDDIs), followed by lisinopril and furosemide (8%). The proportion of clinically significant interactions was only 2%. There was a positive association between pDDIs and the total number of drugs prescribed (P < 0.001).Conclusions: A high prevalence of pDDIs was documented among Nigerian patients with CKD. The bulk of the interactions were related to the co-prescription of ferrous sulphate and calcium carbonate. The total number of drugs prescribed was a significant predictor of pDDIs. We recommend routine screening of prescriptions of CKD patients for potential pDDIs.

scholarly journals The magnitude of undernutrition and associated factors among adult chronic kidney disease patients in selected hospitals of Addis Ababa, Ethiopia

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0251730
Author(s):  
Mahder Asefa ◽  
Amene Abebe ◽  
Behailu Balcha ◽  
Daniel Baza
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Diabetic Nephropathy ◽  
Kidney Disease ◽  
Serum Albumin ◽  
Associated Factors ◽  
Addis Ababa ◽  
Statistical Significance ◽  
P Value ◽  
Reference Laboratory

Background Undernutrition is a common comorbidity in chronic kidney disease patients which augments the progression of the disease to an end-stage renal disease, renal dysfunction and related morbidity and mortality. However, in Ethiopia, there is a dearth of research evidence in this regard. Therefore, this study aimed to assess the magnitude of undernutrition and its associated factors among adult chronic kidney disease patients. Methods An institution-based cross-sectional study was conducted in selected hospitals of Addis Ababa from May to August 2018. Data were collected by structured and pretested questionnaires. Patients’ charts were reviewed from their medical profiles. Body mass index was calculated from anthropometric measurements using calibrated instruments. Serum albumin level was determined by reference laboratory standard procedure. Data were entered into Epi- data version 3.1 and exported to SPSS version 21 for analysis. Descriptive statistics were calculated and presented by tables, graphs and texts. Binary and multivariable logistic regression analyses were computed and the level of statistical significance was declared at p-value <0.05. Results From the total sample size of 403 participants, 371 were involved in the study. The prevalence of undernutrition (BMI<18.5) among adult chronic kidney disease patients was 43.1% (95% CI: 38%-48%). Undernutrition (BMI<18.5) was significantly higher among patients with diabetic nephropathy [AOR = 2.00, 95% CI, 1.09–2.66], serum albumin value less than 3.8g/dl [AOR = 4.21: CI, 2.07–5.07], recently diagnosed with diabetes mellitus [AOR = 2.36, 95% CI, 1.03–3.14] and stage V chronic kidney disease [AOR = 3.25:95% CI, 1.00–3.87]. Conclusion Undernutrition in chronic kidney disease patients was significantly higher among patients with diabetic nephropathy, patients on stage V chronic kidney disease, recently diagnosed with diabetes mellitus and serum albumin value less than 3.8g/dl.

scholarly journals Polypharmacy and potential drug-drug interactions among medications prescribed to chronic kidney disease patients

2021 ◽  
Vol 9 (1) ◽  
pp. 25-32
Author(s):  
Shrijana Kumari Chaudhary ◽  
Naresh Manadhar ◽  
Laxman Adhikari
Keyword(s):  
Chronic Kidney Disease ◽  
Drug Interaction ◽  
Kidney Disease ◽  
Drug Interactions ◽  
Teaching Hospital ◽  
College Teaching ◽  
Potential Drug ◽  
Comorbid Conditions ◽  
Medical College ◽  
Drug Drug Interaction

Background and Objectives: Chronic kidney disease is a major systemic condition. Presence of comorbid conditions with the deteriorating renal function, lead them to use multiple drugs. Polypharmacy is common among chronic kidney disease. The possibility of drug interaction rises when a patients concurrently receive more than one drug and the chances increase with the number of drugs taken, which may be associated with increased morbidity, mortality, length of hospital stay and health-care cost. The aim of this study was to assess the polypharmacy and pattern of drug- drug interactions in chronic kidney disease patients attending OPD and ward of nephrology unit in Kathmandu Medical College teaching hospital. Material and Methods: This was a prospective cross sectional study conducted among 143 chronic kidney disease diagnosed patients in Kathmandu Medical College Teaching Hospital. The Lexi-comp database was used to evaluate patient’s medications for potential drug-drug interactions. Results: Chronic kidney disease was predominant among male (65.7%) than the female (34.3%). The most common age group was 41-60yrs followed by 61-80 yrs. The mean age of the patients was 54.38 ± 16.43 years. Chronic kidney disease was associated with multiple co-morbid conditions. The most common comorbid conditions were hypertension 52 (36. 4%) and hypertension and diabetes both in 42 (29.4%). A total of 143 prescriptions were included in this study. Average number of drugs per prescription was 6.1. Almost 5-8 medicines per prescription were observed among 95(65.73%) patients. A total of 837 medicines were prescribed. A total number of 206 potential drug-drug interactions were observed among 143 patients. Depending upon the risk rating categorize, the most common were,  risk rating C 178( 86.4%) and the most frequent drug interaction was between amlodipine and calcium carbonate 65 (45.45%) . Conclusion: The prevalence of potential drug-drug interaction is high among chronic kidney disease patients. About 63% of interactions have moderate severity. The safest approach to avoid potentials drug-drug interaction is the implementation of appropriate guidelines, detailed and rationalize knowledge of drugs and to utilize available drug-drug interaction software to avoid harmful drug-drug interaction among chronic kidney disease patients.

scholarly journals Prevalence and Associated Factors of Chronic Kidney Disease Among Diabetic and Hypertensive Patients at Ambo Town Public Hospitals of West Shewa Zone, Oromia Region, Ethiopia

2022 ◽  
Author(s):  
Haimanot Ewnetu Hailu ◽  
Belachew Dinku ◽  
Jimmawork Wondimu ◽  
Bilisuma Girma
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Logistic Regression ◽  
Kidney Disease ◽  
Associated Factors ◽  
Public Hospitals ◽  
P Value ◽  
Hypertensive Patients ◽  
Long Duration

Abstract Background: Chronic kidney disease is a global public health important disease that is associated with life threatening outcomes including renal failure and premature mortality unless diagnosed and treated promptly. Diabetes Mellitus and hypertension are the two major causes of chronic kidney disease worldwide. This study is aimed to determine prevalence and associated factors of chronic kidney disease among diabetes mellitus and hypertensive patients at Ambo town public hospitals, EthiopiaMethods: A cross-sectional study was conducted at Ambo University referral and general hospitals on 308 study participants. The participants were interviewed using interviewer administered questionnaire when they come for follow up at a chronic illness follow-up clinic. The patient charts were reviewed to retrieve information regarding medications, blood pressure, serum Creatinine and glucose level. A chronic kidney disease epidemiology collaboration equation was used to estimate Glomerular filtration rate from serum Creatinine. Data were analyzed SPSS version 23 for statistical analysis. Binary logistic regression analysis was used to identify factors associated with chronic kidney disease. Variables with a p-value below 0.2 at bivariable analysis were entered into the multivariable logistic regression model. Multivariable logistic regression analysis was used to examine the association between dependent and independent variable and p-value less than 0.05 was used to declare statistical significance.Results: A total of 308 diabetes mellitus and hypertensive patients were included in the study from Ambo town public hospitals. Of which 156 (50.6%) participants were female with mean (± SD) age of 47.15 ± 12.06 years. The prevalence of chronic kidney disease (stage 3–5) was 20.5% with (95% CI: 16%-25%). Long duration of hypertension (AOR=4.89, 95% CI=1.93-12.40), elevated systolic blood pressure (>140mmHG) (AOR=3.20, 95% CI=1.36-7.51), family history (AOR=3.36, 95% CI=1.56-7.24) and age greater than 55 years (AOR=2.17, 95% CI=1.09-4.31) were predictors of chronic kidney disease.Conclusion: The prevalence of chronic kidney disease was high. Older age, elevated SBP, long duration of hypertension and family history of kidney disease were independent predictors of chronic kidney disease. A preventive plan is mandatory to reduce the disease and complications in the community.

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