scholarly journals A Study on Prescribing Pattern of Antihypertensive in Chronic Kidney Disease Patients

2020 ◽  
Vol 10 (3-s) ◽  
pp. 75-81
Author(s):  
Riny Thomas ◽  
Sini Sam ◽  
P Neelaphar ◽  
P Shabeeb ◽  
B A Vishwanath

Background: Chronic kidney disease causes progressive loss of function which gradually occur overtime leading to decrease in GFR levels leading to dysfunction of renal system. Hypertension is found to be intermingled cause and overlapping complication in CKD. It is important to intervene the progression by controlling the blood pressure to prevent kidney failure by administration of anti-hypertensive. Objectives: To study current trends in anti-hypertensive prescription pattern in CKD patient and to evaluate the concurrent patterns are in adherence according to the guidelines mentioned.  Methods: Prospective observational study was undertaken in patients who were satisfying the inclusion criteria and was enrolled into the study conducted for a 6months period in a tertiary care hospital in Bangalore. Results: 150 CKD patients were examined out of which 72% prevalence seen in males compared to females 28%. Dual drug therapy was most preferred combination seen in 48% of the prescriptions. CCB was the most preferred class of drug and least preferred class of drug was ACE. More than 85% deviation from JNC-8 was seen. 20% of mono-therapy was found in adherence to JNC-8. Conclusion: A 15% adherence to JNC-8 guidelines was observed in the treatment indicating need for clinical pharmacist who play vital role in management of CKD by adherence to JNC-8 to ensure safety, efficacy and rationality. Keywords: Chronic kidney disease, Hypertension, Prescription pattern, JNC-8 guidelines, Compliance, Anti-Hypertensive.  

Author(s):  
Narayana Murthy B. V. ◽  
Satyanarayana V.

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.


2019 ◽  
Vol 51 (1) ◽  
pp. 55
Author(s):  
Denis Xavier ◽  
RashmiKarabasappa Mamadi ◽  
Renuka Sathish ◽  
DhirajRavindran Selvaraj ◽  
Rajni Rathore ◽  
...  

2021 ◽  
Vol 15 (8) ◽  
pp. 2013-2016
Author(s):  
Shahid Ishaq ◽  
Muhammad Imran ◽  
Hashim Raza ◽  
Khuram Rashid ◽  
Muhammad Imran Ashraf ◽  
...  

Aim: To determine correlation of iron profile in children with different stages of chronic kidney disease (CKD) presenting to tertiary care hospital. Methodology: A total of 81 children with chronic kidney disease stage having glomerular filtration rate (GFR) less than 90 (ml/min/m2) aged 1 – 14 years of either sex were included. Three ml serum sample was taken in vial by hospital duty doctor for serum ferritin level, serum iron, transferrin saturation and total iron binding capacity. The sample was sent to hospital laboratory for reporting. Iron profiling was done evaluating hemoglobin (g/dl), serum iron (ug/dl), serum ferritin (ng/ml), transferrin saturation (%) and total iron binding capacity (ug/dl) while iron load was defined as serum ferritin levels above 300 ng/ml. Correlation of iron profile with different stages of CKD was determined applying one-way analysis of variance (ANOVA). Results: In a total 81 children, 46 (56.8%) were boys while overall mean age was 7.79±2.30 years. Mean duration on hemodialysis was 11.52 ± 9.97 months. Iron overload was observed in 26 (32.1%) children. Significant association of age above 7 years (p=0.031) and residential status as rural (p=0.017) was noted with iron overload whereas iron overload was increasing with increase in stages of CKD (p=0.002). Hemoglobin levels decreased significantly with increase in stages of CKD (p<0.001). Serum iron levels increased significantly with increase in the CKD stages (p=0.039). Serum ferritin levels were increasing significantly with the increase in CKD stages (p=0.031). Transferrin saturation also increased significant with increase in CKD stages (p=0.027). Conclusion: High frequency of iron overload was noted in children with CKD on maintenance hemodialysis and there was linear relationship with stages of CKD and iron overload. Significant correlation of hemoglobin, serum iron, serum ferritin and transferrin saturation was observed with different stages of CKD. Keywords: Iron overload, maintenance hemodialysis, ferritin level.


2019 ◽  
Vol 6 (2) ◽  
pp. 271
Author(s):  
Vishnu Shankar H. ◽  
Mahendra Kumar K. ◽  
Jagadeesan M. ◽  
Kannan R. ◽  
Chitrambalam P. ◽  
...  

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.


Author(s):  
BIBHU PRASAD BEHERA

Objective: Efforts can be made to normalize the hematological parameters and slow the progress of the disease so that the morbidity and mortality in these patients with chronic kidney disease could be effectively reduced. Methods: The observational study was carried out in the Department of General Medicine, Pandit Raghunath Murmu Medical College Hospital, Baripada, between May 2018 and January 2019. Two hundred seventy patients of chronic kidney disease (CKD) above 15 years of age, satisfying the inclusion and exclusion criteria, were included in the study. Results: In our study, 179 (66.30%) were male, and 91 (33.70%) were female with M:F of 1.97:1. The average age of the patients in the study was 55.72±12.77 years. About 42.59 % (115) of the patients were between 46 and 60 years of age. About 35.56% of CKD cases had determined etiology and, 64.44% of cases had unknown etiology. Hemoglobin, RBC, and packed cell volume were significantly lower in the patients with CKD compared to the controls (p=0.0001), and RDW was considerably higher in the patients with CKD compared to the controls (p=0.0001). Microcytic anemia was the most prevalent type of anemia. There was a hugely significant association between the prevalence of thrombocytopenia and the severity of CKD (p=0.006). Conclusion: This study concluded that patients with CKD show abnormal hematological parameters. Evaluation of hematological parameters in these patients helps in classifying the type of anemia, aids in choosing the correct treatment modalities, and decreases mortality.


2015 ◽  
Vol 18 (1) ◽  
pp. 20-24 ◽  
Author(s):  
Farzana Sultana ◽  
Ajijur Rahman ◽  
Tripti Rani Paul ◽  
Md Shahid Sarwar ◽  
Md Anwar Ul Islam ◽  
...  

Irrational prescribing of drugs is a major health concern in developing countries like Bangladesh. A study was therefore undertaken in a hospital, situated in Rajshahi region of Bangladesh, to find the prescribing pattern and to detect the prescription errors to the admitted patients. Prescriptions of 200 patients were collected from various departments of the hospital over a period of three months. Prescription pattern was analyzed using general indicators suggested by WHO and prescribing errors were determined by comparing the prescribed drugs with national standard treatment guidelines, textbooks and authentic online resources. The average number of drugs per prescription was found to be 4.89 and 76.5% prescriptions contained complex regimen. In this study, we found no prescription with generic name. The percentage of prescription with antibiotics was 78% that was 15.95% of total drugs. The injectable preparations used were 17.18% of total 978 drugs. About 769 (3.85 per prescription) prescription errors were identified from 978 prescribed drugs. The name of 35 prescribed drugs was not clear due to illegible hand writing. The dose strength was missing for 279 drugs and 31 drugs had improper abbreviation. The study also identified 409 drug interactions. About 6.5% prescription orders were identified for the patients with kidney and urinary problems and there was no dose adjustment. Frequency of occurrence of prescription errors found during the study can be rated high. The prescription pattern and the prescription errors have indicated the need to establish proper system of recording and analyzing therapy before writing a prescription in order to promote rational drug therapy.Bangladesh Pharmaceutical Journal 18(1): 20-24, 2015


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