Deprescribing in chronic kidney disease: An essential component of comprehensive medication management

Résumé fourni par la source

Chronic kidney disease (CKD) is categorized by abnormalities of kidney structure or a sustained reduction (for greater than 3 months) in estimated glomerular filtration rate to less than 60 mL/min/1.73 m2 and/or 2 of 3 urine albumin creatinine ratio measures of 30 mg/g (3 mmol/L) or higher.1 The prevalence of CKD in the US and Canada is 14% (35.5 million) and 12.5% (4 million), respectively.2-8 This corresponds to an estimated 1 in 7 Americans and 1 in 10 Canadians with CKD.2-8 Individuals with advanced CKD receiving kidney replacement therapy have a high medication burden, taking a mean (SD) of 12 (5) medications per day.9-12 Multiple comorbidities, advanced age, and polypharmacy are common in individuals with CKD.9-14 Polypharmacy refers to taking 5 or more medications on a regular basis as well as any inappropriate choices and doses of medications.15 Approximately 70% to 80% of individuals with CKD are prescribed 5 or more medications13,16 and receive a mean (SD) of 5.37 (2.83) potentially inappropriate medications (PIMs).17 Given the potential for adverse consequences associated with polypharmacy, ongoing assessment of medications is crucial. This review aims to highlight the consequences of polypharmacy in individuals with CKD, including those with end-stage kidney disease (ESKD), and provide medication optimization strategies, using deprescribing approaches to enhance medication management.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.