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Abstract: SA-PO293

The Relationship of Polypharmacy with Increasing CKD Stage

Session Information

Category: Pharmacology (PharmacoKinetics, -Dynamics, -Genomics)

  • 2000 Pharmacology (PharmacoKinetics, -Dynamics, -Genomics)

Authors

  • Suzuki, Rie, Tokyo Ika Daigaku, Shinjuku-ku, Tokyo, Japan
  • Moriyama, Takahito, Tokyo Ika Daigaku, Shinjuku-ku, Tokyo, Japan
  • Miyaoka, Yoshitaka, Tokyo Ika Daigaku, Shinjuku-ku, Tokyo, Japan
  • Kanno, Yoshihiko, Tokyo Ika Daigaku, Shinjuku-ku, Tokyo, Japan

Group or Team Name

  • Tokyo Medical University.
Background

Previously, chronic kidney disease (CKD) and hemodialysis has been reported as the one of the risk factors of polypharmacy. However, it has been unclear the relationship of increasing CKD stage with the higher number of medications.

Methods

In this retrospective cohort analysis, 408 CKD patients (CKDG1 and 2 (n=23), CKDG3-5 (n=81) and CKDG5D (n=304) were conducted. We analyzed the backgrounds, the number and details of prescribed medications in January 2017, the number of patients who met STOPP (Screening Tool of Older Person’s Prescriptions) criteria, and the risk factors for polypharmacy (6-9 medications) and hyper-polypharmacy (≧ 10 medications).

Results

The mean number of medications was significantly different among three groups and increased as the higher CKD stage (4.5±2.6 in CKDG1 and 2, 8.0±3.5 in CKDG3-5, and 9.7±3.5 in CKDG5D, p<0.001). The number of patients of polypharmacy and hyper-polypharmacy was increased as the CKD stage (polypharmacy: 26.1% in CKDG1 and 2, 72.8% in CKDG3-5, and 87.2% in CKDG5D, p<0.001, hazard ratio (HR) 3.23/ one stage increase, p<0.001, hyper-polypharmacy: 4.35% in CKDG1 and 2, 32.1% in CKDG3-5, and 51.0% in CKDG5D, p<0.001, HR 2.78/one stage increase, p<0.001). In STOPP criteria, the number of patients who had any duplicate drugs were significantly different among three groups and increased as CKD stage (4.35% in CKDG1 and 2, 14.8% in CKDG3-5, and 27.6% in CKDG5D, p=0.004), and patients who had benzodiazepines for > 4weeks were also significantly different (8.7% in CKDG1 and 2, 7.41% in CKDG3-5, and 24.7% in CKDG5D, p=0.001). Multivariate logistic analysis indicated that CKD stage and diabetes were independent risks for polypharmacy and hyper polypharmacy (polypharmacy: CKD stage; HR 1.62/ one stage increase, p<0.001, and diabetes: HR 2.23 (vs. without DM), p=0.007, hyper polypharmacy: CKD stage; HR 1.54, p<0.001, and diabetes: HR 1.64, p=0.017).

Conclusion

The number of medications, patients with polypharmacy, and the risk for polypharmacy were increased as higher CKD stage.