A Prospective Observational Study on Pattern of Drug Use and Burden of Polypharmacy in Patients with Chronic Kidney Disease in A Tertiary Hospital

Background: Chronic kidney disease (CKD) represents a global public health burden with increasing prevalence worldwide.Suitable drug selection for patients with CKD is vital to avoid undesirable drug effects and to ensure optimum patient outcomes.Prescription pattern studies provide us the information regarding extent and profile of drug use, trends, standard treatment guidelines and overall, facilitates the rational use of drugs in a population.This study was undertaken, as despite the recognized challenging circumstances of pharmacotherapy in CKD patients, there are only few studies reported in the Indian literature about prevailing pattern of prescribing drugs, the burden of polypharmacy and predisposing factors in CKD, requiring more systematic studies.Objective: To assess the prescribing pattern for chronic kidney disease (CKD), to find out the burden of polypharmacy & to assess comorbidities in CKD.Methodology: 75 consecutive subjects of either gender aged >18yrs attending Department of Nephrology on outpatient and inpatient basis were recruited to the present study.Subjects diagnosed as per KDIGO classification to have chronic kidney disease by treating Nephrologist at Kempegowda Institute of Medical Sciences Hospital, Bangalore, were included and assessed for current therapy for CKD, comorbid conditions including type, duration, number of comorbidities and number of drugs / drug combinations used. Results:The mean age group of study subjects was 55.1213.4years, with male preponderance.Majority of subjects were on 6 medications per day and most common comorbidity was hypertension. Conclusion:The most common comorbidity was hypertension followed by diabetes and majority of subjects were suffering with CKD stage 4 and most prescribed CKD medication was N-Acetylcysteine + Taurine, antihypertensives were calcium channel blockers, antidiabetics were Soluble Insulin/ Insulin Isophane 30/70 and Tenligliptin, IHD medication was Aspirin + Atorvastatin and for anemia Darbepoetin.