THE IMPACT OF POLYPHARMACY DUE TO NON-CKD MEDICATIONS AMONG CKD PATIENTS

 

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https://storage.unitedwebnetwork.com/files/1099/6d57761c47e19d6fef48743e9d272029.pdf
THE IMPACT OF POLYPHARMACY DUE TO NON-CKD MEDICATIONS AMONG CKD PATIENTS

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Hiroshi
Kimura
Hiroshi Kimura kimuhiro@fmu.ac.jp Fukushima Medical University Nephrology and Hypertension Fukushima Japan *
Kenichi Tanaka kennichi@fmu.ac.jp Fukushima Medical University Nephrology and Hypertension Fukushima Japan -
Hirotaka Saito wba7vtjx@fmu.ac.jp Fukushima Medical University Nephrology and Hypertension Fukushima Japan -
Syuhei Watanabe uchimed@fmu.ac.jp Fukushima Medical University Nephrology and Hypertension Fukushima Japan -
Michio Shimabukuro mshimabukuro-ur@umin.ac.jp Fukushima Medical University Diabetes, Endocrinology, and Metabolism Fukushima Japan -
Koichi Asahi asahik@iwate-med.ac.jp Iwate Medical University, Nephrology and Hypertension Yahaba Japan -
Tsuyoshi Watanabe twat0423@yahoo.co.jp Fukushima Medical University Advanced Community Based Care for Lifestyle Related Diseases Fukushima Japan -
Junichiro James Kazama jjkaz@fmu.ac.jp Fukushima Medical University Nephrology and Hypertension Fukushima Japan -
 
 
 
 
 
 
 

Polypharmacy is common in patients with chronic kidney disease (CKD) and is associated with several adverse outcomes. However, its impact on medications for the management of CKD and non-CKD has not been adequately elucidated. Therefore, we aimed to investigate relationships among polypharmacy, medication for CKD management, and renal prognosis, mortality, and cardiovascular events in patients with CKD.

We conducted a retrospective cohort study using 1247 CKD patients enrolled in the Fukushima cohort study. Patients were categorized into three groups based on the number of prescribed medications: non-polypharmacy (<5 medications), polypharmacy (5–9 medications), and hyper-polypharmacy (≥ 10 medications). In addition, we defined medications for CKD management (hypertension, diabetes, dyslipidemia, hyperuricemia, and cardiovascular diseases) as CKD medications.

The median age was 65 years, 57% were men, and the median eGFR was 50.7 ml/min/1.73 m2. The mean number of medications was 8.2; the numbers of medications for CKD were 3.6, and for non-CKD were 0.9, respectively. The hyper-polypharmacy group showed an increased risk of renal events, all-cause death, and cardiovascular events. Furthermore, a higher number of non-CKD medications was associated with an elevated risk of renal events, all-cause death, and cardiovascular events. However, the higher number of CKD medications was not associated with any of the outcomes.

Hyper-polypharmacy due to non-CKD medications was associated with an increased risk of several adverse outcomes in CKD patients.

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