title: Aging and antihypertensive medication-related complications in the chronic kidney disease patient.
abstract: OBJECTIVE
  We have reviewed the recent literature to describe the potential medication errors and adverse drug events (ADEs) associated with antihypertensives among older adults with chronic kidney disease (CKD).
  
  
  RESULTS
  Overall, few studies have been published describing ADEs in older adults with CKD. Several examined hyperkalemia associated with angiotensin-converting enzyme (ACE)-inhibitor/angiotensin II receptor blocker (ARB), diuretic (potassium-sparing), and β-blocker use. Additional studies described acute kidney injury (AKI) most commonly with ACE-inhibitor/ARB therapy. Finally, orthostatic hypotension was evaluated in those taking ACE-inhibitor/ARB, β-blocker, or calcium-channel blocker therapy. In the absence of robust literature examining these events in this understudied population, one must consider age-related antihypertensive pharmacokinetic/pharmacodynamic profiles concomitantly with the patient's comorbidities and other medications in order to minimize the risk for potential medication errors, drug-drug interactions, and ADEs.
  
  
  CONCLUSIONS
  Some of the most common ADEs associated with antihypertensive use in older adults with CKD include hyperkalemia, AKI, and orthostatic hypotension. Diligent monitoring of laboratory data, vital signs, and potential drug-drug interactions may mitigate serious ADEs caused by antihypertensives in this high-risk patient population.
authors.affiliation: Division of Geriatric Medicine, Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA. zam12@pitt.edu
authors.forename: Zachary A
authors.initials: ZA
authors.lastname: Marcum
authors.forename: Linda F
authors.initials: LF
authors.lastname: Fried
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D000959:Antihypertensive Agents / Q000009:adverse effects*; D002908:Chronic Disease; D015897:Comorbidity; D004347:Drug Interactions; D016903:Drug Monitoring; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D007674:Kidney Diseases / Q000150:complications* / Q000503:physiopathology; D008508:Medication Errors / Q000517:prevention & control*; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D000959:Antihypertensive Agents