Low baseline eGFR may increase risk for adverse drug reactions in patients with CKD
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Key takeaways:
- Kidney and urinary disorders, as well as hemorrhages, accounted for 70% of documented adverse drug reactions.
- The highest risk medications were antithrombotics and renin-angiotensin system inhibitors.
Lower baseline eGFR was identified as a major risk factor for adverse drug reactions in patients with chronic kidney disease, according to a recently published data.
“Patients with chronic kidney disease have complex clinical presentations, take multiple medications and often receive inappropriate prescriptions,” Solène M. Laville, PharmD, PhD, and colleagues wrote. “Using data from a large, prospective CKD cohort, we found a high incidence of serious adverse drug reactions.”
The prospective cohort study included 3,033 patients from the French Chronic Kidney Disease-Renal Epidemiology and Information Network. The researchers used hospital discharge reports, medical records and patient interviews to identify adverse drug reactions among patients with CKD.
The researchers found 360 patients had 488 serious adverse drug reactions during a median follow-up of 4.7 years. Most of the reactions (467) required hospitalization.
Kidney and urinary disorders and hemorrhages were the most common, making up 70% of adverse drug reactions documented. The most common medications involved in adverse reactions were antithrombotics and renin-angiotensin system inhibitors.
Patients’ eGFR was identified as a risk factor for adverse drug reactions. For each 1 mL/min/1.73 m2 lower baseline eGFR, the risk for AKI increased 2.2% and the risk for bleeding increased 8%.
“This report enhances our understanding of the potential toxicity of drugs taken by patients with moderate-to-advanced CKD,” the researchers wrote. “It emphasizes the importance of monitoring kidney function when prescribing drugs, particularly for high-risk medications such as antithrombotic agents.”
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