A Prospective Observational Study on Drug Utilization in Renal Impaired Patients at Tertiary Care Teaching Hospital

Abstract

Renal impairment is characterized by a progressive decline in glomerular filtration rate, a significant public health issue worldwide associated with high morbidity and mortality. In most cases, renal impairment is associated with comorbidities such as hypertension and diabetes, which require multiple drug therapy during a course of treatment, leading to polypharmacy. The objective of this study was to assess the prescribing pattern of drugs in renal-impaired patients at Dhiraj General Hospital. A total of 150 patients with renal impairment were finally recruited after strictly obeying the selection criteria in this cross-sectional, observational study conducted over 6 months in a tertiary care teaching hospital, directorate general of hydrocarbons. Relevant data were extracted by interviewing the patients and from prescriptions, case records, and investigational reports. Of the total 150 patients, 94 (63%) were male and 56 (37%) female. The highest numbers of patients were in the age group >60 years (59 patients, 39.3%). Anemia was the most common comorbidity (143 patients, 95%) observed, followed by hypertension (129 patients, 86%) and diabetes mellitus (64 patients, 43%). A total of 1693 drugs were prescribed to 150 renal-impaired patients. Each patient received an average of 11.19 ± 3.51 (8%) drugs. Polypharmacy was seen in all patients. Drugs acting on the cardiovascular system constituted the bulk of the prescriptions (25.87%), followed by gastrointestinal (GI) drugs (18.72%), vitamins and minerals (14.94%), and antibiotics (8.33%). There is polypharmacy in patients with renal impairment due to associated comorbidities. The prevalence of polypharmacy was high in patients with chronic kidney disease (CKD). Antihypertensive drugs, drugs used for the GI system, antibiotics, and antidiabetic drugs were frequently used in CKD patients.