Chronic kidney disease (CKD) -a brand ambassador/alarming bell for potentially inappropriate medication in elderly inpatients

2021 ◽  
Vol 14 ◽  
Author(s):  
Rishabh Sharma ◽  
Parveen Bansal ◽  
Manik Chhabra ◽  
Malika Arora
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Inappropriate Medication ◽  
Tertiary Care ◽  
The Elderly ◽  
Potentially Inappropriate Medication ◽  
Beers Criteria ◽  
Care Hospital ◽  
Cross Sectional ◽  
Elderly Inpatients

Background: In the past decade, the prevalence of Potentially Inappropriate Medication (PIM) among elderly inpatients has increased drastically. However, limited data is available on PIM indicators, and PIMs use among the elderly in patients with Chronic Kidney Disease (CKD). Objective: To determine the prevalence of PIMs in elderly hospitalized patients with CKD. Methods: A cross-sectional study was carried out on 102 patients in a tertiary care hospital. PIMs were identified using Beers criteria 2019. A Chi-square test was used to determine the association between variables and PIMs use. Results: PIMs, as assessed according to AGS updated Beers criteria 2019 was found to be in more than 68.6% of patients of median age 65years and 3 number of diagnoses and seven days median length of stay. Most of the patients (47.1%) had ≥four diagnoses. The most common comorbidities in the patient were diabetes mellitus (n=54) and hypertension (n=55). Most of the subjects (66.7%) were on polypharmacy (5-9 medications/day), and 25.5% were on a higher level of polypharmacy (>10 medicines/day). Approximately 90% of the patients had very low CrCl < 21ml/min (calculated with the help of Cockcroft- Gault formula). A significant association between PIM use and an increased number of diagnoses, polypharmacy or high-level polypharmacy, was observed. Conclusion: The prevalence of PIMs in elderly inpatients suffering from CKD is relatively high. The study indicates negligence/ lack of awareness amongst physicians leading to increase PIM use. The authors propose that the CKD patients should attract the special attention of the physician and should be treated as brand ambassadors or alarming bells for PIM use.

scholarly journals A study of secondary hyperparathyroidism in patients with chronic kidney disease in a tertiary care hospital

2019 ◽  
Vol 6 (2) ◽  
pp. 271
Author(s):  
Vishnu Shankar H. ◽  
Mahendra Kumar K. ◽  
Jagadeesan M. ◽  
Kannan R. ◽  
Chitrambalam P. ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Secondary Hyperparathyroidism ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Study Population ◽  
Chronic Morbidity ◽  
Spss Software

Background: Secondary hyperparathyroidism (SHPT) is one of the less recognized complications in patients with chronic kidney disease (CKD). The prevalence of SHPT in various stages of CKD was evaluated by measuring the levels of intact parathyroid hormone (iPTH).Methods: This cross-sectional study was carried out in 100 CKD patients. Serum creatinine, calcium, phosphorous and iPTH levels were measured and statistical analysis was carried out using the SPSS software (IBM, NY, USA).Results: Among the 100 participants, the mean age (SD) was 59.3 (7.8) years. In our study population, 52% were men and the rest were females. Hypertension (75%) was the most common chronic morbidity. Prevalence of hyperparathyroidism among chronic kidney disease patients was 22% (95% CI: 14.7-30.9%). The prevalence of secondary hyperparathyroidism among dialysis and non-dialysis patients were 30% and 14% respectively which was statistically significant.Conclusions: SHPT is an important complication which is often underdiagnosed. Secondary hyperparathyroidism starts to develop when eGFR falls below 60ml/min. PTH levels starts to rise as the disease progress. Hence it is important for the treating physicians to monitor the PTH levels early in the course of CKD to prevent and treat bone mineral disease.

scholarly journals Pattern of UTI in Chronic Kidney Disease: Experience from A Tertiary Care Hospital, Bangladesh

2021 ◽  
Vol 20 (1) ◽  
pp. 41-45
Author(s):  
Marina Arjumand ◽  
Golam Mohammad Tayeb Ali ◽  
Pradip Kumar Dutta ◽  
Md Habib Hassan ◽  
Kazi Md Abrar Hasan ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Tertiary Care ◽  
Urine Samples ◽  
Care Hospital ◽  
Biochemical Tests ◽  
Gram Positive ◽  
College Hospital ◽  
Cross Sectional ◽  
Gram Negative

Background: Urinary Tract Infection (UTI) is common and higher in prevalence in patients with Chronic Kidney Disease (CKD). To find out the frequency and clinicobacteriological pattern of UTI in CKD patients. Materials and methods: A cross-sectional study was done on 1000 of CKD patients attending Nephrology Department of Chattogram Medical College Hospital (CMCH) a tertiary level hospital in Bangladesh during January to December, 2017. Cleancatch midstream urine samples were collected from study populations irrespective of symptoms. Macroscopic and microscopic examinations were done. Urine samples were then inoculated in Blood agar and Mac’Conkey agar and incubated aerobically at 37 °C for 18-24 hours. Microscopic observations and conventional biochemical tests were done to identify the isolated organisms. Significant growth of organisms in urine was defined as UTI. The isolated organisms were tested for antimicrobial susceptibility by using modified Kirby Bauer technique. Results: The prevalence of UTI was 61.8%. with significant asymptomatic UTI for 28%. Gram-negative organisms were most frequent 564 (93%) with predominant Escherichia coli 399 (64%) followed by Klebsiella 113(18%) and Pseudomonas 39(6%). Among Gram positive isolates, Staphylococcus (6%) was the dominant organism isolated. Regarding antibiotic susceptibility, Gram-negative microorganisms were found to be most sensitive to carbapenem and amikacin whereas Gram-positive microorganisms were most sensitive towards carbapenem, colistin and linezolid. Conclusion: In CKD patients, asymptomatic UTI was detected significantly. E.coli was found to be predominant organisms and resistant towards most of the studied common antibiotics. Chatt Maa Shi Hosp Med Coll J; Vol.20 (1); January 2021; Page 41-45

scholarly journals PREVALENCE OF DEPRESSION AND ITS ASSOCIATED FACTORS AMONG PATIENTS OF CHRONIC KIDNEY DISEASE IN A TERTIARY CARE HOSPITAL FROM ASSAM: A CROSS-SECTIONAL STUDY.

2019 ◽  
Vol 3 (11) ◽  
Author(s):  
Hamad Jeelani ◽  
Manzoor A. Parry ◽  
Shruti Dange
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Prevalence Of Depression

Background: Chronic kidney disease (CKD) patients are at high risk of depressive disorders because of considerable psychological stress due to physical and social changes brought on by disease. The aim of this study is to assess the prevalence of depression in patients with CKD and the factors affecting it at a public tertiary care hospital. Methods: This cross-sectional study was carried out at the renal clinic of a tertiary care hospital. Data on 629 patients diagnosed with CKD from September 2014 to April 2016 was obtained. Nine-item Patient Health Questionnaire from PRIME-MD was used to assess the depression. Results: Of all the patients, 44.7% had depression. Mild depression was found to affect 28.9% of the patients followed by moderate depression and severe depression (15.4% and 0.4%, respectively). According to multiple logistic regression, the occurrence of depression was significantly higher with age below 60 years [odds ratio (OR) 1.5, 0.9–2.7; P<0.05], male gender (OR 1.4, 1.0–3.1; P<0.05), no treatment funding (OR 2.7, 1.3–4.6; P<0.05), education less than grade 12 (OR 1.3, 1.3–3.2; P<0.05), monthly income ≤INR 20,000 (OR 1.6, 1.1–3.6; P<0.05), CKD stage V (OR 1.4 1.0– 2.9; P <0.05), Patients on hemodialysis (HD) (OR 2.5, 1.2–4.5; P<0.05), comorbidities ≥3 (OR 1.6, 1.3–3.0; P<0.05), overweight (OR 2.4, 1.3–2.9; P<0.05), and duration of CKD >2 (OR 2.4, 1.4–4.4; P<0.05). Conclusion: About 44.7% of the patients were found to have depression. Patients’ age, gender, body mass index, treatment funding, education status, income, CKD duration and stage, HD status, and comorbidities were found to be significant factors affecting depression.

scholarly journals Prescribing pattern of drugs in chronic kidney disease patients on hemodialysis at a tertiary care hospital

2017 ◽  
Vol 6 (4) ◽  
pp. 928
Author(s):  
Narayana Murthy B. V. ◽  
Satyanarayana V.
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Tertiary Care ◽  
Hypoglycemic Agents ◽  
Phosphate Binders ◽  
Care Hospital ◽  
Oral Hypoglycemic Agents ◽  
Prescribing Pattern ◽  
Cross Sectional ◽  
Mortality And Morbidity

Background: CKD (chronic kidney disease) is a general term for heterogeneous disorders affecting kidney structure and its function. It is defined as either kidney damage or a decreased glomerular filtration rate of less than 60 mL/min/1.73m2 for 3 or more months. Objective of present work is to study the drug utilization pattern in chronic kidney disease patients undergoing hemodialysis.Methods: After taking the clearance and approval from the institutional ethics committee, a cross sectional prospective observational study conducted on chronic kidney disease (CKD) patients undergoing hemodialysis, in the department of nephrology, of Rajarajeshwari Medical College and Hospital, Bangalore. The data was analyzed descriptively.Results: Study included 52 patients, among them 41 males, 11were females, with a mean age of 47.6yrs. In our study large number pt were suffering from hypertension (HTN) 88.46% (46), in them the calcium channel blocker (CCB) 08.48% (38) was most commonly prescribed anti hypertensive drug. Around 1/3 of pt suffering from diabetes mellitus (DM) 36.53% (19) most of these patients were treated with them treated with oral hypoglycemic agents (OHA), and less than half of pt treated with insulin01.56% (07). Other drugs like phosphate binders (calcium carbonate & acetate) used in 11.16% (50), aspirin in 08.70% (39), statins in 10.04% (45) pt were being most commonly prescribed drugs.  Totally 448 drugs were prescribed In 52 pts Ie about 8.61 drugs / prescription, showing poly pharmacy.Conclusions: Patients undergoing hemodialysis with CKD will be having multiple diseases associated, regular monitoring and counseling regarding these diseases and its complication may reduce the incidence of CKD and the mortality and morbidity associated. The poly pharmacy noted in the study found inevitable because of the multifactorial etiologiesinvolved and needful multi-interventional approach towards it.

scholarly journals Evaluation of Rationality of Geriatric Patients’ Prescription Based On Beers Criteria in a Tertiary Care Hospital in India

2019 ◽  
Vol 7 (6) ◽  
pp. 987-991
Author(s):  
Nader Motallebzadeh ◽  
Geetha Jayaprakash ◽  
Elham Mohammadi
Keyword(s):  
Health Care Providers ◽  
Geriatric Patients ◽  
Inappropriate Medication ◽  
Tertiary Care ◽  
Potentially Inappropriate Medication ◽  
Inappropriate Drug ◽  
Beers Criteria ◽  
Care Hospital ◽  
Care Providers ◽  
Inappropriate Medications

AIM: Irrational prescribing for geriatric patients has become an important public health problem worldwide. Because India is one of the most populated countries having a great proportion of old people in the world, studies on the prevalence of inappropriate prescriptions can be very beneficial to increase the knowledge of health care providers and to reduce the occurrence of adverse drug events among this population. METHODS: A group of 482 inpatients above 64 years old were enrolled in a prospective study. Chart review method was used. The data were collected from patients’ prescription and medicine charts. Each prescription was checked individually for the inappropriate drug by using the AGS 2015 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. Suggestions were given to the physicians for inappropriate medications. RESULTS: The prevalence of potentially inappropriate medication is found to be 11.66% (n = 56). Out of 56 inappropriate medications, the most frequently inappropriate medication is Digoxin (25%) followed by Sprinolactone 19.64%. This study founds age, some medication, length of stay and number of diagnosis as predictors for getting a PIM. Feedback of the physicians varies based on the suggestions. CONCLUSION: This study concludes that the prevalence of PIMs among geriatrics patients of ≥ 65 years old is 11.66%. Some predictors have been identified for getting a PIM. This study shows that physicians’ feedback is dependent on the suggestions being given.  

scholarly journals Family impact and economic burden among caregivers of children with chronic kidney disease in Assiut, Egypt

2020 ◽  
Vol 95 (1) ◽  
Author(s):  
Manal M Darwish ◽  
Shimaa Hosny Hassan ◽  
Samaher Fathy Taha ◽  
Hosnia Said Abd El-Megeed ◽  
Taghreed Abdul-Aziz Mohammad Ismail
Keyword(s):  
Chronic Kidney Disease ◽  
Health Insurance ◽  
Chronic Disease ◽  
Kidney Disease ◽  
Economic Burden ◽  
Tertiary Care ◽  
Financial Hardship ◽  
Care Hospital ◽  
Family Impact ◽  
Cross Sectional

Abstract Background Chronic disease greatly increases children’s dependency on parents/caregivers (usually mothers) as they face new problems associated with caring for a child with chronic disease. Thus, chronic kidney disease (CKD) presents a burden for children and their families that last throughout life in different aspects. This study aimed to assess family impact and economic burden of chronic kidney disease (CKD) in children on their families. Methods A cross-sectional study was carried out on 250 caregivers of children with CKD attending tertiary care hospital/health insurance clinics in Assiut, Egypt using PedsQL™ family impact module (FIM) for assessing family impact and economic burden between January and May 2018. Results Seventy six percent of caregivers shared paying for treatment with health insurance while 14% paid the total expenses out of their pockets. Although the majority (87.2%) of caregivers suffered different degrees of financial hardship, more than 60% of them had no coping strategy. The regression module showed that responding caregiver, degree of financial hardship, treatment modality, and socioeconomic class were significant predictors of total FIM (β = 0.38, P < 0.001; β = 0.28, P < 0.001; β = 0.22, P < 0.001; β = 0.13, P = 0.006 respectively). Conclusion Most caregivers were involved in paying for treatment of their children either totally or sharing with health insurance and suffered different degrees of financial hardship. Mothers, caregivers with great financial hardship, and caregivers of children on dialysis had the lowest scores of PedsQL™ FIM. There is a high need for expansion of health insurance umbrella to reduce financial hardship together with continued multidimensional support to families.

Sign in / Sign up

Export Citation Format

Share Document