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Abstract: TH-PO1072

The Burden of Polypharmacy in Patients with CKD: The GCKD Study

Session Information

Category: CKD (Non-Dialysis)

  • 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Schmidt, Insa Marie, University Medicine-Charite, Berlin, Germany
  • Huebner, Silvia, University Erlangen, Nuremberg, Germany
  • Nadal, Jennifer, IMBIE, Bonn, Germany
  • Titze, Stephanie I., KBV, Berlin, Germany
  • Schmid, Matthias, University of Erlangen-Nuremberg, Erlangen, Germany
  • Bärthlein, Barbara, Medical Centre for Information and Communication Technology (MIK), University Hospital Erlangen, Erlangen, Germany
  • Schlieper, Georg, MVZ DaVita Karlstraße, Duesseldorf, Germany
  • Dienemann, Thomas, University of Erlangen-Nuremberg, Erlangen, Germany
  • Schultheiss, Ulla T., Medical Center - University of Freiburg, Freiburg, Germany
  • Meiselbach, Heike, Nephrology and Hypertension, Erlangen, Germany
  • Kottgen, Anna, Medical Center - University of Freiburg, Freiburg, Germany
  • Floege, Jürgen, RWTH University of Aachen, Aachen, Germany
  • Busch, Martin, University Hospital Jena, Jena, Germany
  • Kreutz, Reinhold, Charite-University Medicine Berlin, Berlin, Germany
  • Kielstein, Jan T., Academic Teaching Hospital Braunschweig, Braunschweig, Germany
  • Eckardt, Kai-Uwe, University Medicine-Charite, Berlin, Germany
Background

Patients with chronic kidney disease (CKD) bear a substantial burden of comorbidities leading to the prescription of multiple medications. However, data on medication use patterns in this population is scarce. This study uses data of a longitudinal, multicentre study in CKD patients to evaluate drug use trajectories as well as the prevalence of polypharmacy and its associated risk factors over 4 years of observation.

Methods

We analyzed data of 5217 patients aged 18– 74 years with an estimated glomerular filtration rate (eGFR) between 30–60 ml/min/1.73m^2 or an eGFR ≥60 and overt proteinuria (>500 mg/d) who participated in the German Chronic Kidney Disease (GCKD) study. Self-reported data on current medication use assessed at baseline (2010-2012) and after 4 years of follow-up were used for this analysis. Prevalence and risk factors associated with polypharmacy (defined as the use of ≥5 drugs/d) as well as initiation or termination of polypharmacy were evaluated using multivariable logistic regression.

Results

The prevalence of polypharmacy at baseline and follow-up was almost 80 % and ranged from 62 % in patients with eGFR >90 ml/min/1.73m^2 to 86 % in those with eGFR 30–45 ml/min/1.73m^2. Patients took on average 7 medications per day (range 0-20), most frequently beta blockers, ACE-inhibitors and statins. In multivariate analysis, female sex and a lower educational level were independently associated with polypharmacy. Increasing CKD stage, age and BMI as well as diabetes mellitus, cardiovascular disease and a history of smoking were significantly associated with both, the prevalence of polypharmacy and the maintenance of polypharmacy over time. Comorbid diabetes mellitus was a significant risk factor for the initiation of polypharmacy in CKD patients (OR 2.46, p=0.003).

Conclusion

This study highlights the medication burden in CKD patients and strongly suggests that further research is needed to address the risks of polypharmacy in this vulnerable population.

Funding

  • Government Support - Non-U.S.