title: Prescribing patterns of medicines in chronic kidney disease patients on maintenance hemodialysis.
abstract: OBJECTIVE
  To study medicine prescribing pattern for chronic kidney disease (CKD) patients on maintenance hemodialysis.
  
  
  METHODS
  This prospective observational study was conducted in hemodialysis unit of a teaching hospital with adult CKD patients on maintenance hemodialysis. Patients' clinical profile, drug-use pattern, and medication-related problem data were captured in a structured case report form and the data were analyzed descriptively. Adherence level was assessed by Morisky Medication-Taking Adherence Scale 4-item.
  
  
  RESULTS
  Data from 100 patients recruited over 6 months have been analyzed. The median (interquartile range [IQR]) age was 51 (42-57) years; 57% were male, mean [standard deviation (SD)] urea level was 160.11 (70.32) mg/dL, mean (SD) creatinine level was 8.73 (5.29) mg/dL. A large number (46%) were suffering from diabetic nephropathy. The common comorbidities were anemia (89%) followed by hypertension (85%). The median (IQR) number of drugs per prescription was 10 (9-13), with the bulk being cardiovascular drugs (23.41%) followed by gastrointestinal drugs (15.76%) and vitamins (12.29%). The median (IQR) number of potential drug-drug interaction per prescription was 2 (2-3). The incidence of adverse drug reactions (ADRs) was 46% with hyponatremia being most common (32%), followed by hypoglycemia (16%) and hypokalemia (10%). Adherence level was low in the majority (64%) of patients.
  
  
  CONCLUSIONS
  There is a high incidence of polypharmacy along with significant medication-related problems such as high drug-drug interactions/prescription, high incidence of ADRs, and low adherence.
authors.affiliation: Department of Pharmacology, R.G.Kar Medical College, Kolkata, West Bengal, India.
authors.forename: Sourav
authors.initials: S
authors.lastname: Chakraborty
authors.affiliation: Department of Pharmacology, R.G.Kar Medical College, Kolkata, West Bengal, India.
authors.forename: Saugata
authors.initials: S
authors.lastname: Ghosh
authors.affiliation: Department of Pharmacology, R.G.Kar Medical College, Kolkata, West Bengal, India.
authors.forename: Avishek
authors.initials: A
authors.lastname: Banerjea
authors.affiliation: Department of Pharmacology, R.G.Kar Medical College, Kolkata, West Bengal, India.
authors.forename: Radha Raman
authors.initials: RR
authors.lastname: De
authors.affiliation: Department of Pharmacology, IPGMER, Kolkata, West Bengal, India.
authors.forename: Avijit
authors.initials: A
authors.lastname: Hazra
authors.affiliation: Department of Hemodialysis, R.G.Kar Medical College, Kolkata, West Bengal, India.
authors.forename: Swapan Kumar
authors.initials: SK
authors.lastname: Mandal
mesh_terms: D000328:Adult; D004347:Drug Interactions; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D015994:Incidence; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D019338:Polypharmacy; D010818:Practice Patterns, Physicians'; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy* / Q000628:therapy*
keywords: Chronic kidney disease; diabetic nephropathy; hemodialysis; medication adherence; prescribing patterns