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

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.

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

10.21203/rs.2.21799/v1 ◽

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.

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

African Journal of Nephrology ◽

10.21804/22-1-3577 ◽

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.

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

Janaki Medical College Journal of Medical Science ◽

10.3126/jmcjms.v9i1.38047 ◽

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.

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