Identify potentially inappropriate medications in older adults with chronic kidney disease and deprescribe when possible

Abstract

Older adults with chronic kidney disease (CKD) often receive treatment with multiple medications and are vulnerable to adverse treatment-related outcomes. Although specific guidelines for deprescribing (defined as the process of eliminating or reducing the use of unnecessary and/or inappropriate medications) in older patients with CKD are lacking, a systemic process should be used to assess the individual patient, identify the use of potentially inappropriate medications (PIMs), and deprescribe such medications when possible. Dosage tapering is needed when some commonly used PIMs (e.g. proton pump inhibitors and oral antidiabetic drugs) are deprescribed, but not when others (e.g. statins) are discontinued. Patient involvement and a collaborative approach are important factors in the success of the deprescribing process.