Turkish Journal of Nephrology
Original Articles

Medication Prescribing Patterns for Chronic Kidney Diseases: Analysis of Drug-Dose Adjustments, Polypharmacy, and Drug Interactions

1.

Department of Medicine, Khoja Akhmet Yassawi International Kazakh-Turkish University, Turkestan, Kazakhstan

2.

Department of Public Health and Management, Astana Medical University, Astana, Kazakhstan

3.

Department of Medicine, Nazarbayev University School of Medicine, Astana, Kazakhstan

4.

Department of Ophthalmology, Kazakh National Research Institute of Eye Disease, Astana, Kazakhstan

5.

Department of Emergency Medical Care and Nursing, South Kazakhstan Medical Academy, Shymkent, Kazakhstan

6.

Department of Oncology, City multidisciplinary hospital with oncology center, Shymkent, Kazakhstan

7.

Department of Clinical Pharmacology and Therapy, Russian Medical Academy of Continuous Professional Education, Moscow, Russian Federation

Turkish J Nephrol 2024; 33: 324-332
DOI: 10.5152/turkjnephrol.2024.24764
Read: 72 Downloads: 34 Published: 12 September 2024

Background: Multiple drug prescriptions in chronic kidney disease (CKD) escalate metabolic buildup, nephrotoxicity, and end stage kidney disease progression. We aimed to study polypharmacy and harmful multi-drug interactions at the nephrology department of South-Kazakhstan Regional hospital.

Methods: We analyzed electronic medical records of 485 patients with glomerular diseases (ICD-10 codes: N00-N08) admitted to the nephrology department from January 2018 to December 2021. We evaluated polypharmacy risk, dividing patients into low-risk, moderate-risk, and severe-risk groups based on the number of prescribed medications: 2-5, 6-9, and 10 or more, respectively. Additionally, we examined the occurrence and combinations of unsafe multi-drug interactions.

Results: The study group included 45% CKD stage-1, 29% CKD stage-2, and 26% CKD stage-3 and above patients, with a median medication count of 9.5. Low-risk, moderate-risk, and severe-risk polypharmacy afected 12.2%, 48.2%, and 39.6% of patients, respectively. Inappropriate multi-drug combinations were particularly prevalent in early CKD stages. Notably, among commonly prescribed drugs, 19 out of 23 lacked dose adjustments according to the CKD stage.

Conclusion: This pioneering study investigates polypharmacy and multi-drug interactions in CKD patients in Kazakhstan, revealing signifcant risks.

Cite this article as: Assan A, Kerimbayeva Z, Moldaliyev I, et al. Medication prescribing patterns for chronic kidney diseases: Analysis of drug-dose adjustments, polypharmacy, and drug interactions. Turk J Nephrol. 2024;33(4):324-332.

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