Rational Use of Medicines and Medication Adherence in Chronic Kidney Disease on Maintenance Hemodialysis.

Abstract

Chronic kidney disease is associated with abnormal structural and functional changes in the kidney and its main unit nephrons, which lead to abnormal urine output and impaired excretory function. CKD is also associated with hypertension, diabetes, obesity, and other renal disorders. So After crossing the stages, the renal failure reaches to end-stage renal disorder (ESRD) which is the fifth stage of CKD according to the NKF. Dialysis in the patient individual is done in the end stage, i.e., when the kidney loses its function by about 80 – 90% and when the GFR rate is 15 ml/min. In CKD the maintenance of hemodialysis is done by some medications like antiplatelet (heparin), erythropoietin-stimulating agents, and iron drugs and sometimes if the patient is hypertension, ACE inhibitors are used. A descriptive study, which was conducted on 120 dialysis patients. Data were collected by using a structured questionnaire from December 2020 to June 2021 and then analyzed using SPSS version 20.0 software. Out of the 120 patients who were undergoing dialysis, 83 patients were male and 37 patients were females. According to age group classification, the age group of 40 to 50 years old, or 38 (31.7%), was the most afflicted. CKD (80%) was the most common diagnosis, followed by AKI (10.3%). The most common type of dialysis was an AV fistula (70%) followed by a jugular (25%). The most common comorbidity was hypertension with diabetes mellitus (58.3%) The most common complications were anemia (35.4%) followed by edema (26.24%). Finally, medication adherence was 76.7%. This study indicated that patients who underwent and were undergoing dialysis procedures were majorly affected by CKD. Mostly followed, a type of dialysis was an AV fistula with comorbid condition HTN and diabetes mellitus. The results of the study, which was conducted has minor complications, no major drug interactions, and lower medication adherence, which was developed later by patient education by counseling the patient.