Inappropriate use of nonsteroidal anti-inflammatory drugs and other drugs in chronic kidney disease patients without renal replacement therapy

Abstract

Objective: The main goal of chronic kidney disease (CKD) treatment is the prevention of progression of the disease and complications. Inappropriate drug use in patients with CKD is an important issue, which may cause adverse effects on patients and progression of chronic renal failure. The aim of this study is to find the rate of inappropriate drug use among CKD patients. Methods: The subjects of this study were selected from the patients with a CKD history of minimum one year, who did not receive renal replacement therapy. Patients were asked to provide a digital record of the drugs they used over the last one year. Individually, for each patient, the drugs that may be contraindicative and that require dose adjustment were identified based on glomerular filtration rate (GFR). Results: This study includes a total of 185 participants – 97 female (52.4%) and 88 male (47.6%) patients. The average age of patients was 60.50 ± 14.56. It was shown that 149 patients (80.5%) were using inappropriate drugs. Seventy (47.0%) were using one, 79 (53.0%) two, 30 (20/1%) three, and 9 (6.4%) four inappropriate drugs. Of CKD patients, 44.3% were aged 65 or over; and in this age group, inappropriate drug use was more frequent compared to the population below 65 (86.6% vs. 75.7%). The drugs used inappropriately were, respectively, nonsteroidal anti-inflammatory drugs (65.8%), quinolone antibiotics (39.0%), ACE inhibitors (26.9%). Discussion: Health professionals are required to consider renal functions of all patients, mainly those aged over 65, when administering a treatment.