Prevention of Adverse Drug Reactions in Patients with Chronic Kidney Disease

Chronic Kidney Disease, an Escalating Global Health Challenge

Kidney disease is accountable for an estimated 1.3 million fatalities each year, positioning it as the tenth most prevalent cause of mortality on a global scale. The diagnosis of chronic kidney disease (CKD) is established when the estimated glomerular filtration rate (GFR) falls below 60 ml/min/m3. CKD, with a worldwide prevalence ranging from 11% to 13%, is an escalating public health issue. The prevalence of renal impairment is increasing in Sub-Saharan Africa and Uganda. CKD patients are at increased risk of DRPs including adverse drug reaction (ADR). 

Prioritizing Patients with Chronic Kidney Disease in prevention of Adverse Drug Reactions   

An ADR refers to any unanticipated and harmful consequence of drugs that manifests at typical dosage levels. Patients with CKD are at a significantly higher risk of adverse drug reactions (ADRs) compared to the general population. ADRs cause up to 20% of hospitalizations in CKD patients. Mortality due to ADRs is 2–3 times higher in CKD compared to patients with normal kidney function. The level of renal impairment is substantially linked to mortality following an ADR. The implementation of medication therapy management (MTM) led by pharmacists has demonstrated efficacy in the prevention of ADRs among patients with CKD elsewhere. MTM services have the potential to enhance medication adherence, reduce healthcare expenditures, and enhance the quality of life (QoL) for those diagnosed with CKD. MTM consists of five distinct steps: medication therapy review (MTR), personal medication record (PMR), medication-related action plan (MAP), intervention or referral, and paperwork.