Evaluation of drug-drug interactions in chronic kidney disease patients: A single-center experience

Document Type : Research Paper

Authors

1 Department of Pharmacology & Toxicology, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran

2 Department of Clinical Pharmacy, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran

3 Department of Pharmaceutics, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran

4 Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran

5 Department of Pharmacology and Toxicology, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran

10.22034/ijps.2020.109154.1567

Abstract

Drug-drug interactions (DDIs) result from the simultaneous consumption of two or more drugs that alter the patient’s response to the initial drug. The treatment regimen in patients with kidney disease is very diverse and may be associated with several diseases that increases the risk of DDIs. This study was carried out to investigate the DDIs incidence in patients with chronic kidney disease (CKD) in the nephrology ward. This descriptive-analytical study was performed in a 4-month period in 2017. The patients’ information such as age, sex, list of drugs during hospitalization, and kidney disease stage were recorded from patients’ medical records. Drug-drug interactions were extracted using LexiComp Online. In this study 48.55% of patients were male, 51.45% were female and 53.2% of patients were in stage 5 of kidney disease. There was a significant correlation between the incidence of drug-drug interactions with stage 5 of disease (P=0.02). The highest number of interactions was categorized as type C and interaction between atorvastatin and pantoprazole was the most frequent interaction. The maximum range of prescription drugs was between 6 and 10 items by 49.7% of patients. There was a significant correlation between the incidence of drug-drug interactions and the number of prescribed drugs (P=0.03). Drug-drug interactions are common in patients with chronic kidney disease. Based on the results, the number of prescribed drugs and the stage of the disease is effective in drug-drug interactions incidence. It is possible to reduce drug complications and increase the life span of patients by recognizing drug-drug interactions.

Keywords


[1] Weir MR and Fink JC. Safety of medical therapy in patients with chronic kidney disease and end-stage renal disease. Curr. Opin. Nephrol. Hypertens. (2014) 23: 306-13.
[2].Dolatabadi M and JALILI RH. Patterns of physicians’ drug preh1ion in sabzevar iran. J. Sabzevar. Uni. Med. Sci. (2009) 16: 161-66.
[3] Lubinga SJ and Uwiduhaye E. Potential drug-drug interactions on in-patient medication prescriptions at Mbarara Regional Referral Hospital (MRRH) in western Uganda: prevalence, clinical importance and associated factors. Afr. Health. Sci. (2011) 11: 499-507.
[4] Nabovati E, Vakili-Arki H, Taherzadeh Z, Hasibian MR, Abu-Hanna A and Eslami S. Drug-drug interactions in inpatient and outpatient settings in Iran: a systematic review of the literature. DARU. J. Pharm. Sci. (2014) 22: 52.
[5] Amkreutz J, Koch A, Buendgens L, Muehlfeld A, Trautwein C and Eisert A. Prevalence and nature of potential drug-drug interactions among kidney transplant patients in a German intensive care unit. Int. J. Clin. Pharm. (2017) 39: 1128-39.[6] Roblek T, Vaupotic T, Mrhar A and Lainscak M. Drug-drug interaction software in clinical practice: a systematic review. Eur. J. Clin. Pharmacol. (2015) 71: 131-42.
[7] De Almeida M, Gama CS and Akamine N. Prevalence and classification of drug-drug interactions in intensive care patients. Einstein. (2007) 5: 347-51.
[8] Papadopoulos J and Smithburger PL. Common drug interactions leading to adverse drug events in the intensive care unit: management and pharmacokinetic considerations. Crit. Care. Med. (2010) 38: 126-35.
[9] Ötles S and Senturk A. Food and drug interactions: a general review. Acta. Sci. Pol. Technol. Aliment. (2014) 13: 89-102. [10] Azad N, Tierney M, Victor G and Kumar P. Adverse drug events in the elderly population admitted to a tertiary care hospital. J. Healthc. Manag. (2002) 47: 295-305.
[11] Rashidi K, Bahmani N, Ghotbi N and SHAHSAVARI S. Study of prevalence of neonatal Septicaemia and detection of antibiotic resistance in Besat Hospital in Sanandaj in 1383. Scientific. J. Kurdistan. Uni. Med. Sci. (2006) 10: 26-32.
[12] Abbasi Nazari M and Khanzadeh Moqhadam N. Evaluation of pharmacokinetic drug interactions in prescriptions of intensive care unit (ICU) in a teaching hospital. Iran. J. Pharm. Res. (2010) 5: 215-18.
[13] Lima REF and Cassiani SHDB. Potential drug interactions in intensive care patients at a teaching hospital. Rev. Latinoam. Enfermagem. (2009) 17: 222-27.
[14] Hammes JA, Pfuetzenreiter F, Silveira Fd, Koenig Á and Westphal GA. Potential drug interactions prevalence in intensive care units. Rev. Bras. Ter. Intensiva. (2008) 20: 349-54.
[15] Levey AS, Eckardt KU, Tsukamoto Y, Levin A, Coresh J, Rossert J, De Zeeuw D, Hostetter TH, Lameire N and Eknoyan G. Definition and classification of chronic kidney disease: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney. Int. (2005) 67: 2089-100.
[16]         Rama M, Viswanathan G, Acharya LD, Attur R, Reddy P and Raghavan S. Assessment of drug-drug interactions among renal failure patients of nephrology ward in a South Indian Tertiary Care Hospital. Indian. J. Pharm. Sci. (2012) 74: 63-8.
[17] Chacko SC, Shareef J and Kamath J. Assessment of drug-drug interactions in chronic kidney disease patients in nephrology unit of a tertiary care teaching hospital. Am. J. Pharm. Res. (2016) 6: 4962-9.
[18] Tavakoli-Ardakani M, Kazemian K, Salamzadeh J and Mehdizadeh M. Potential of drug interactions among hospitalized cancer patients in a developing country. Iran. J. Pharm. Res. (2013) 12: 175-82.
[19]         Van Leeuwen R, Swart E, Boven E, Boom F, Schuitenmaker M and Hugtenburg J. Potential drug interactions in cancer therapy: a prevalence study using an advanced screening method. Ann. Oncol. (2011) 22: 2334-41.
[20] Lubinga S and Uwiduhaye E. Potential drug-drug interactions on in-patient medication prescriptions at Mbarara Regional Referral Hospital (MRRH) in western Uganda: prevalence, clinical importance and associated factors. Afr. Health. Sci. (2011) 11: 499-507.
[21] Rizvi SAH and Manzoor K. Causes of chronic renal failure in Pakistan: a single large center experience. Saudi. J. Kidney. Dis. Transpl. (2002) 13: 376-9.
[22] Astor BC, Matsushita K, Gansevoort RT, van der Velde M, Woodward M, Levey AS, Jong PE, Coresh J; Chronic Kidney Disease Prognosis Consortium, Astor BC, Matsushita K, Gansevoort RT, van der Velde M, Woodward M, Levey AS, de Jong PE, Coresh J, El-Nahas M, Eckardt KU, Kasiske BL, Wright J, Appel L, Greene T, Levin A, Djurdjev O, Wheeler DC, Landray MJ, Townend JN, Emberson J, Clark LE, Macleod A, Marks A, Ali T, Fluck N, Prescott G, Smith DH, Weinstein JR, Johnson ES, Thorp ML, Wetzels JF, Blankestijn PJ, van Zuilen AD, Menon V, Sarnak M, Beck G, Kronenberg F, Kollerits B, Froissart M, Stengel B, Metzger M, Remuzzi G, Ruggenenti P, Perna A, Heerspink HJ, Brenner B, de Zeeuw D, Rossing P, Parving HH, Auguste P, Veldhuis K, Wang Y, Camarata L, Thomas B and Manley T. Lower estimated glomerular filtration rate and higher albuminuria are associated with mortality and end-stage renal disease. A collaborative meta-analysis of kidney disease population cohorts. Kidney. Int. (2011) 79: 1331-40.
[23] Derosa G, Libetta C, Esposito P, Borettaz I, Tinelli C, D'angelo A and Maffioli P. Effects of two different dialytic treatments on inflammatory markers in people with end-stage renal disease with and without type 2 diabetes mellitus. Cytokine. (2017) 92: 75-9.
[24] Martins Castro MC, Luders C, Elias RM, Abensur H and Romao Junior JE. High-efficiency short daily hemodialysis-morbidity and mortality rate in a long-term study. Nephrol. Dial. Transplant. (2006) 21: 2232-8.
[25] Salahi H, Mehdizadeh A, Derakhshan A, Davari H, Bahador A, Mashhadieh B, Bagheri F and Malek-hosseini SA. Evaluation the Cause of End-Stage Renal Disease (ESRD) in Kidney Transplant Patients-A Single Center Study. Iran. J. Med. Sci. (2015) 29: 198.
[26] Mylapuram VG, Leelavathi AA and Reddy P. A study on drug- drug interaction in renal failure patients of a tertiary care teaching hospital in south India. World. J. Pharm. Res. (2012) 3: 1403-10.
[27] Venturini CD, Engroff P, Ely LS, Zago LF, Schroeter G, Gomes I, De Carli GA and Morrone FB. Gender differences, polypharmacy, and potential pharmacological interactions in the elderly. Clinics. (2011) 66: 1867-72.
[28] Vyas A, Pan X and Sambamoorthi U. Chronic condition clusters and polypharmacy among adults. Int. J. Family. Med. (2012) 2012: 193168.
[29] Delafuente JC. Understanding and preventing drug interactions in elderly patients. Crit. Rev. Oncol. Hematol. (2003) 48: 133-43.
[30] Marquito AB, Fernandes NMdS, Colugnati FAB and Paula RBd. Identifying potential drug interactions in chronic kidney disease patients. J. Bra. Nefrol. (2014) 36: 26-34.