Abstract
BackgroundThe use of nephrotoxic drugs can further worsening renal function in chronic kidney disease (CKD) patients. It is therefore imperative to explore prescribing practices that can negatively affect CKD patients.AimTo analyze the use of nephrotoxic drugs in CKD patients in a general population of Southern Italy during the years 2006–2011.MethodsThe general practice “Arianna” database contains data from 158,510 persons, registered with 123 general practitioners (GPs) of Caserta. CKD patients were identified searching: CKD-related ICD-9 CM codes among causes of hospitalization; CKD-relevant procedures undergone in hospital (e.g. dialysis); drug prescriptions issued for a CKD-related indication. A list of nephrotoxic drugs was compiled and validated by pharmacologists and nephrologists. The summary of product characteristics was used to classify drugs as ‘contraindicated’ or ‘to be used with caution’ in renal diseases. Frequency of nephrotoxic drug use, overall, by drug class and single compounds, by GPs within one year prior or after first CKD diagnosis and within one year after dialysis entry was calculated.ResultsOverall, 1,989 CKD patients and 112 dialysed patients were identified. Among CKD patients, 49.8% and 45.2% received at least one prescription for a contraindicated nephrotoxic drug within one year prior or after first CKD diagnosis, respectively. In detail, 1,119 CKD patients (56.3%) had at least one nonsteroidal anti-inflammatory drugs (NSAIDs) prescription between CKD diagnosis and end of follow-up. A large proportion of CKD patients (35.6%) were treated with NSAIDs for periods exceeding 90 days. Contraindicated nephrotoxic drugs were used commonly in CKD, with nimesulide (16.6%) and diclofenac (11.0%) being most frequently used.ConclusionsContraindicated nephrotoxic drugs were highly prescribed in CKD patients from a general population of Southern Italy. CKD diagnosis did not seem to reduce significantly the prescription of nephrotoxic drugs, which may increase the risk of preventable renal function deterioration.
Highlights
Chronic kidney disease (CKD) is a progressive and widely prevalent disorder worldwide
Contraindicated nephrotoxic drugs were highly prescribed in chronic kidney disease (CKD) patients from a general population of Southern Italy
CKD diagnosis did not seem to reduce significantly the prescription of nephrotoxic drugs, which may increase the risk of preventable renal function deterioration
Summary
Chronic kidney disease (CKD) is a progressive and widely prevalent disorder worldwide. End stage renal disease (ESRD) requiring dialysis or kidney transplantation is a frequent outcome in patients with CKD stage. CKD may progress toward ESRD which results in a significant reduction of patient and relatives quality of life due to increasing morbidity and disability, in addition to increasing healthcare costs [8]. These observations underline the urgent need for strategies to prevent renal diseases [9]. The use of nephrotoxic drugs can further worsening renal function in chronic kidney disease (CKD) patients. It is imperative to explore prescribing practices that can negatively affect CKD patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
