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Abstract
Background
Chronic kidney disease (CKD) is one of the widely prevalent non-communicable diseases that is responsible for increasing morbidity in India. Drug therapy of CKD is complex and inevitably requires poly-pharmacy with frequent monitoring of drugs and their dosage adjustments.
Objectives
The main objective of the study was to identify the potential Drug-Drug Interactions (DDIs) among Chronic Kidney Disease (CKD) patients and to assess the risk factors possibly associated with these interactions.
Material and methods
After Institutional Ethics Committee approval, a prospective Cross-sectional study was carried out for a period of six months from 1st June 2017 to 30th November 2017 at department of Nephrology, of a tertiary care hospital. Patients diagnosed with CKD by treating Nephrologist were included and their prescriptions analysed. The prescriptions were then analysed for potential DDIs using MEDSCAPE multidrug interaction checker tool.
Results
Among 120 prescriptions, 79 patients had at least one interacting drug combination. Total number of potential DDI were 235. Majority of interactions were pharmacodynamic (50.21%) in nature. Severity assessment showed that majority of DDIs were moderate (64.68%) followed by minor (29.78%). Out of total prescribed drugs (618), DDIs were most commonly seen with cardiovascular class of drugs (46.8%). Considering individual drugs, five most commonly involved drugs in potential DDIs were calcium salts, aspirin, clonidine, furosemide and prazosin. Calcium carbonate +amlodipine were common drug combinations involved in potential DDI. Elderly age group, co-morbid conditions and increased number of drugs were the risk factors associated with the potential DDI.
Conclusions
This study highlights the need for proper therapeutic planning, routine monitoring of CKD patients, screening of prescriptions for potential DDIs to prevent possible DDIs.