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Abstract: TH-PO304

Reducing Polypharmacy in Dialysis Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Jameson, Travis R., Loyola University Medical Center, MAYWOOD, Illinois, United States
  • Schneider, Julia, Loyola University Medical Center, Maywood, Illinois, United States
  • Kramer, Holly J., Loyola University Medical Center, Maywood, Illinois, United States
Background

Polypharmacy is a freqent problem for patients receiving maintenance dialysis and may increase risk of adverse events and drug interactions. Previous studies have identified 4 drug classes (proton pump inhibitors [PPI], alpha 1 blockers [A1B], diuretics, and statins) in which use may not be necessary in patients receiving maintenance dialysis. This study examined overall medication use and use of 4 non-essential drug classes.

Methods

This study was comprised of 168 patients receiving maintenance dialysis at a single dialysis unit. The mean age was 60.4 (SD 15.8) and median dialysis vintage was 2.4 years with a range of 0.2 to 13.9 years. Overall 49.1% were male. Diabetes mellitus (49.1%) and hypertention (18.0%) were the two main causes of end stage renal disease. The average number of prescribed medications was 11 (SD 5) and ranged from 2-26 medications but was higher among women (11[SD 4]) than among men (10[SD 5]).

Results

Of the 4 non-essential drugs, 51.5% were taking at least one of these drugs, 36.9% were taking at least 2, and 11.5% were taking at least three non-essential medications. Statin use was most common at 56.3% overall and among patients age 70+ years, 75% were using statins. PPI and diuretic use wee noted in 32.5% and 31.7% respectively. A1B use was noted in 8.5% of men with a dialysis vintage of 2.4 years. If the 4 non-essential drugs were eliminated, the average number of medications would decrease to 9 (SD 4) overall, to 9 (SD 5) among men and to 10 (SD 4) for women.

Conclusion

In conclusion, use of non-essential medications is common among patients receiving maintenance dialysis. Elimination of non-essential medications would lead to a reduction of about 1 medication on average. Targeted de-prescribing may help reduce polypharmacy in this patient population.