Abstract
Background: Patients with end-stage renal disease (ESRD) require specialized therapeutic interventions. The decreased renal function that modulates the physiology and presence of comorbidities is often associated with variations in the pharmacological response, thus increasing the risk of adverse drug events or reactions (ADE/ADRs) from co-administered drugs. Methods: A cross-sectional study to record comorbidities, drug–drug interactions (DDIs), ADE/ADRs in patients with chronic kidney disease of stage five in Greece. The study enrolled 60 patients of mean age 64.8 ± 12.9 years, undergoing hemodialysis three times a week. Demographic and social factors, comorbidities, laboratory test data, medication regimens, DDIs and the reporting of ADE/ADRs were analyzed. Results: Cardiovascular diseases and diabetes were the main comorbidities. In total, 50 different DDIs of various clinical significance were identified. CNS, GI-track, and musculoskeletal-system-related ADE/ADRs were most often reported by patients. ADE/ADRs as clinical outcome from DDIs were associated in 64% of the total identified DDIs. There was a positive trend between number of medications, ADE/ADRs report and DDIs. Conclusions: The impact of ADE/ADRs in ESRD patients should be always considered. Guidelines as well as continuous training in the context of evidence-based clinical practice by healthcare personnel on therapy administration and prevention of adverse events are important.
Highlights
Chronic kidney disease (CKD) is characterized from a progressing reduction in renal function, and end-stage renal disease (ESRD) patients end up requiring renal replacement therapy (RRT).CKD is an important health issue worldwide with high morbidity and mortality rates among the non-communicable diseases
adverse drug events (ADEs)/adverse drug reactions (ADRs) as clinical outcome from drug–drug interactions (DDIs) reported back in 64% of the total identified DDIs; 93% of reported ADE/ADRs are related with Central Nervous System (CNS), GI-track and musculoskeletal system; ADE/ADRs that are observed in ESRD can be related to disease state in some cases
The physiology changes from disease appears thatoccurrence patients of have Apart a highoflevel of medication burden, which canprogression, be related toitthe frequent on dialysis have associated a high levelnot of only medication burden, which can be related to the frequent occurrence side effects with disease complications and with administered medication or of side effectsprocedures associated not with disease complications and with administered medication therapy suchonly as hemodialysis
Summary
Chronic kidney disease (CKD) is characterized from a progressing reduction in renal function, and end-stage renal disease (ESRD) patients end up requiring renal replacement therapy (RRT).CKD is an important health issue worldwide with high morbidity and mortality rates among the non-communicable diseases. Considering ESRD patients, demographics data from several studies reveal a tendency to increase the size of the patient population as well as their age, highlighting the importance of advanced nephrological healthcare [4]. Regarding Greece, epidemiological data show a high incidence and prevalence rate for ESRD patients, with approximately 0.5–1 million patients and 1500 deaths related to CKD [2,5]. CKD patients embody a clinical group that requires special therapeutic interventions to treat the complications and co-existing comorbidities such as diabetes, cardiovascular diseases, metabolic bone. Patients with end-stage renal disease (ESRD) require specialized therapeutic interventions. Methods: A cross-sectional study to record comorbidities, drug–drug interactions (DDIs), ADE/ADRs in patients with chronic kidney disease of stage five in Greece. 50 different DDIs of various clinical significance were identified
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