Prevalence and Determinants of Medication Related Problems in AcuteKidney Injury Patients at Tertiary Teaching and Referral Hospital inKenya

Abstract

Background: Acute Kidney Injury (AKI) is a common illness especially among critically ill patients. The incidence is 2-3 cases per 1000. Seventy percent of the cases are found in the Sub-Sahara African. The proportion of drug- induced AKI is about 25%. Hence there is a need to identify the medication related problems in AKI patients which will facilitate identification, prevention and improved patient outcomes. Objective: To establish the prevalence and determinants of medication related problems in patients with AKI at Kenyatta National Hospital. Methods: This study was a cross-sectional survey that was conducted among patients with AKI at Kenyatta National Hospital. Consecutive random sampling was used to select 92 participants. Data was collected using researcher administered questionnaire and analyzed using STATA version 15. The level of significance was set at p ≤ 0.05. Results: The average age of the participants was 51(± 15.96) years. Medication related problems (57, 62%) identified were associated with the severity of AKI (p=0.014) with the most prevalent being over dosage (59, 64.1%, p=0.002) and drug-drug interactions (44, 47.8%, 0.037). Acute decompensated heart failure (25, 27.2%) was more prevalent comorbidity followed by Obstructive uropathy (18, 19.5%). The main independent predictors of AKI severity were alcohol use (p=0.021), drug overdose (p=0.001) and obstructive uropathy (p=0.014). Conclusion and recommendations: Medication related problems as a precipitating factor of AKI cannot be underscored particularly in the presence of comorbidities. It is therefore recommended that AKI management protocols and policies be developed to address the gaps and involve pharmacists in the bedside medication management.