Potential Drug Interactions among Adult Patients with Chronic Kidney Disease Undergoing Haemodialysis at a Tertiary Referral Hospital in Kenya

Abstract

Background: The complexity of medication regimens among adult patients with chronic kidney disease undergoing hemodialysis predispose to potential drug interactions. The management of patients with chronic kidney disease on haemodialysis may be improved by the knowledge on the predictors of potential drug interactions. Study Objective: To assess the predictors of potential drug interactions among adult patients with chronic kidney disease undergoing haemodialysis at Kenyatta National Hospital. Methodology: This was a cross-sectional study among 120 conveniently sampled adult patients with chronic kidney disease undergoing haemodialysis at renal department of Kenyatta National Hospital. Details of sociodemographic and clinical characteristics of the participants as well as the drugs prescribed for the comorbid illnesses were extracted from medical records and fed onto SPSS version 27 software. Lexicomp drug interaction checker was used to identify types and severity of the potential drug interactions. Pearson’s Chi-square and Fisher’s exact test were used to find associations between the participants’ characteristics with potential drug interactions at statistical significance of p≤0.05. Results: There was female preponderance at 66 (55%). The mean age of the participants was 47.1 (SD 16.0) years and more than half, 67(55.8%) were between 19 to 50 years of age. One hundred and ten (91.7%) had potential drug interactions. Three-fifths, 73 (61.0%) had 0-5 number of interacting drug pairs. There was statistically significant association between the participants’ number of years since diagnosis of chronic kidney disease (p=0.051) and, polypharmacy (p<0.001) with potential drug interactions. The participants’ highest education level (p=0.049), polypharmacy (p<0.001), years since diagnosis (p=0.010) and, number of prescribers (p=0.019) significantly influenced the severity of potential drug interactions. Conclusion: The prevalence of potential drug interactions among adult patients with chronic kidney disease patients undergoing haemodialysis was high due to polypharmacy and advanced years since diagnosis of the disease. Clinicians should intensely monitor the adverse effects of polypharmacy among patients with chronic kidney disease undergoing haemodialysis. A large prospective study would provide enough time for determination of causation of drug interactions and likely areas of mitigation among the patients with chronic kidney disease.