Severity and Risk Rating of Drug-Drug Interaction Potency in Chronic Kidney Disease in Public Health Hospital
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Abstract
Background: Chronic kidney disease has emerged as a prominent cause of mortality worldwide in the last two decades. Drug interactions are a significant problem in individuals with chronic kidney disease, as they often receive numerous concurrent treatments. The aim is to examine the frequency of drug-drug interactions in outpatient treatment for chronic renal disease, classified according to their severity and risk level. Furthermore, the study aims to demonstrate the combined effect of the most common drug-drug interactions potency and associated risk factors.
Methods: This study is a retrospective cross-sectional analysis of outpatients diagnosed with chronic kidney disease at Ansari Saleh Public Hospital in Banjarmasin, Indonesia. Medical records from 2022 were obtained retrospectively from computerised sources. The evaluation of potential interactions between drugs was conducted using Lexicomp®. The categorical data were displayed as percentages, and the continuous variables were depicted as means.
Results: The study found that most drug interactions fell into the moderate severity (77.1%) and category C (75.5%) for the risk assessment. The prevalence of drug-drug interactions was 83.6% and the average number of potential drug interactions per patient was 3.34 ± 3.481. The concurrent use of candesartan and furosemide was the most prevalent drug-drug interaction (5.1%). The number of prescribed medications was a notable determinant for probable drug-drug interactions (p < 0.05).
Conclusion: Identifying and averting potential drug-drug interactions is crucial to guarantee patient safety.
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25. Andriani S, Rahmawati F, Andayani TM. Drug dose adjustment in hozpitalized patients with chronic kidney disease in Tegal Distric Hospital, Indonesia. Majalah Farmaseutik. 2021;17(1):46–53.
26. Makmur SA, Madania M, Rasdianah N. Overview of drug interactions in chronic renal failure patients in the hemodialysis process. Indonesian Journal of Pharmaceutical Education. 2022;2(3):218–29.
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28. Yanti E, Kristin E, Yasmina A. Potential drug interactions in hypertensive patients in liwa district hospital, Lampung Barat, Indonesia. International Journal of Pharmacy and Pharmaceutical Sciences. 2017;134–8.
29. Rachmaini F, Juwita DA, Abdillah R, Wati YM. The comparison between combination of candesartan-amlodipine and candesartan-furosemide on blood pressure in hypertensive patients with chronic kidney disease. Pharmaciana. 2022;12(2):218–26.
30. Kidney Disease: Improving Global Outcomes (KDIGO) Blood Pressure Work Group. KDIGO 2021 Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney Disease. Kidney Int. 2021;99(3S):S1-S87.
31. Sari OM, Cahaya N, Susilo YH. Study of the use of beta-blocker group drugs in inpatients of Ansari Saleh Hospital Banjarmasin. Jurnal Farmasi Udayana. 2020;9(2):123.
32. Pugh D, Gallacher PJ, Dhaun N. Management of hypertension in chronic kidney disease. Drugs. 2019;79(4):365–79.
33. Pea F. β-Blockers and diltiazem combination—bear in mind the risk of heart block. JAMA Intern Medi. 2017;177(10):1543–4.
34. Kalash A, Abdelrahman A, Al-Zakwani I, Al Suleimani Y. Potentially harmful drug-drug interactions and their associated factors among hospitalized cardiac patients: a cross-sectional study. Drugs Real World Outcomes. 2023;10(3):371–81.
35. Zhang JR, Wang DQ, Du J, et al. Efficacy of clopidogrel and clinical outcome when clopidogrel is coadministered with atorvastatin and lansoprazole: a prospective, randomized, controlled trial. Medicine (Baltimore). 2015;94(50):e2262.
36. Wang ZY, Chen M, Zhu LL, et al. Pharmacokinetic drug interactions with clopidogrel: updated review and risk management in combination therapy. Ther Clin Risk Manag. 2015;11:449–67.
2. Ayenew W, Asmamaw G, Issa A. Prevalence of potential drug-drug interactions and associated factors among outpatients and inpatients in Ethiopian hospitals: a systematic review and meta-analysis of observational studies. BMC Pharmacol Toxicol. 2020;21(1):63.
3. Hammoud KM, Sridhar SB, Rabbani SA, Kurian MT. Evaluation of potential drug-drug interactions and adverse drug reactions among chronic kidney disease patients: An experience from United Arab Emirates. Tropical Journal of Pharmaceutical Research. 2022;21(4):853–61.
4. Khusfiani T, Soetikno V, Hustrini NM, Nafrialdi N. Evaluation of potential drug-drug interactions and association with adverse drug reactions in predialysis chronic kidney disease patients at Indonesian national referral hospital. Acta Medica Indonesiana. 2023;55(3):277.
5. Ammirati AL. Chronic Kidney Disease. Rev Assoc Med Bras (1992). 2020;66Suppl 1(Suppl 1):s03–9.
6. Kovesdy CP. Epidemiology of chronic kidney disease: an update 2022. Kidney Int Suppl. 2022;12(1):7–11.
7. Kemenkes R. Laporan Nasional Riskesdas Tahun 2018. Jakarta: Kementerian Kesehatan Republik Indonesia; 2018.
8. Panneerselvam P, Kotakala CMK, Ravichandiran D. Drug-Drug Interactions among Chronic Kidney Disease patients in a tertiary hospital. Medica Innovatica. 2021;10(2):34–40.
9. Santos-Díaz G, Pérez-Pico AM, Suárez-Santisteban MÁ, García-Bernalt V, Mayordomo R, Dorado P. Prevalence of potential drug–drug interaction risk among chronic kidney disease patients in a Spanish hospital. Pharmaceutics. 2020;12(8):713.
10. Sari OM, Putra AMP, Azizah PN, Sofia S. Therapy profile and drug use analysis of chronic kidney disease patients hospitalized at Dr. H. M. Ansari Saleh Hospital. Jurnal Farmasi Galenika (Galenika Journal of Pharmacy) (e-Journal). 2023;9(2):233–46.
11. Indriani L, Bahtiar A, Andrajati R. drug related problems evaluation of chronic kidney disease patients in inpatient department of Fatmawati General Hospital. Journal of Management and Pharmacy Practice. 2013;3(1):39–45.
12. Njeri LW, Ogallo WO, Nyamu DG, Opanga SA, Birichi AR. Medication-related problems among adult chronic kidney disease patients in a sub-Saharan tertiary hospital. Int J Clin Pharm. 2018;40(5):1217–24.
13. Sundus A, Tan MP, Sellappans R. Drug-related problems encountered by community-dwelling older persons in The Klang Valley, Malaysia: An Exploratory Study. Journal of Health and Translational Medicine (JUMMEC).2021;24(1):63–9.
14. Hidayati N, Susilo R, Anggraeni M. Study of drug interaction potency among chronic kidney disease patients in the outpatient of “X” Hospital Cirebon City. Pharmacon: Jurnal Farmasi Indonesia. 2020;17:157–64.
15. Rengga MPE, Kono RB, Beama CA. Drug interaction analysis of chronic kidney disease in Prof. Dr. W. Z. Johannes Kupang. MPI (Media Pharmaceutica Indonesiana). 2021;3(3):179–87.
16. Farnoud M, Mohammadi M, Mehrpooya M, Mahboobian MM, Mohammadi Y. Evaluation of Drug-Drug Interactions in Chronic Kidney Disease Patients: A Single-Center Experience: Drug-drug Interaction in Nephrology Ward. Iranian Journal of Pharmaceutical Sciences. 2020;16:81–92.
17. Shetty V, Chowta MN, Chowta K N, Shenoy A, Kamath A, Kamath P. Evaluation of Potential Drug-Drug Interactions with Medications Prescribed to Geriatric Patients in a Tertiary Care Hospital. J Aging Res. 2018;2018:1–5.
18. Pehlivanli A, Selçuk A, Eyüpoğlu Ş, Ertürk Ş, Özçelikay AT. Potentially Inappropriate Medication Use in Older Adults with Chronic Kidney Disease. Turk J Pharm Sci. 2022;19(3):305–13.
19. Hosseini E, Shojaei L, Karimpour H, Shahbazi F. Potential drug-drug interactions in critically ill medical patients: a cross-sectional study. J Pharm Care. 2018;6(3-4):52–7.
20. Marcath LA, Xi J, Hoylman EK, Kidwell KM, Kraft SL, Hertz DL. Comparison of Nine Tools for Screening Drug-Drug Interactions of Oral Oncolytics. J Oncol Pract. 2018;14(6):e368–74.
21. Lexicomp. Drug Interaction Checker [Internet]. Wolster Kluwer Lexicomp; 2023. Available from: https://www.wolterskluwer.com/en/solutions/lexicomp/lexicomp
22. Suryaman A, Bakhriansyah M, Yustikasari I, Nurikhwan P, Adiputro D. Risk of adverse drug-drug interactions in heart failure patients with co-morbidity chronic kidney disease prescribed polypharmacy. BIO Web of Conferences. 2023;75.
23. Shouqair TM, Rabbani SA, Sridhar SB, Kurian MT. Evaluation of Drug-Related Problems in Chronic Kidney Disease Patients. Cureus. 2022;14(4):e24019.
24. Olumuyiwa JF, Akinwumi AA, Ademola OA, Oluwole BA, Ibiene EO. Prevalence and pattern of potential drug-drug interactions among chronic kidney disease patients in South-Western Nigeria. Nigerian Postgraduate Medical Journal. 2017;24(2):88.
25. Andriani S, Rahmawati F, Andayani TM. Drug dose adjustment in hozpitalized patients with chronic kidney disease in Tegal Distric Hospital, Indonesia. Majalah Farmaseutik. 2021;17(1):46–53.
26. Makmur SA, Madania M, Rasdianah N. Overview of drug interactions in chronic renal failure patients in the hemodialysis process. Indonesian Journal of Pharmaceutical Education. 2022;2(3):218–29.
27. Sari OM, Putra AMP, Wasiaturrahmah Y, Rahmah N. Factors associated with potential drug interactions in covid-19 hospitalized patients. Jurnal Sains dan Kesehatan. 2023;5(5):559–67.
28. Yanti E, Kristin E, Yasmina A. Potential drug interactions in hypertensive patients in liwa district hospital, Lampung Barat, Indonesia. International Journal of Pharmacy and Pharmaceutical Sciences. 2017;134–8.
29. Rachmaini F, Juwita DA, Abdillah R, Wati YM. The comparison between combination of candesartan-amlodipine and candesartan-furosemide on blood pressure in hypertensive patients with chronic kidney disease. Pharmaciana. 2022;12(2):218–26.
30. Kidney Disease: Improving Global Outcomes (KDIGO) Blood Pressure Work Group. KDIGO 2021 Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney Disease. Kidney Int. 2021;99(3S):S1-S87.
31. Sari OM, Cahaya N, Susilo YH. Study of the use of beta-blocker group drugs in inpatients of Ansari Saleh Hospital Banjarmasin. Jurnal Farmasi Udayana. 2020;9(2):123.
32. Pugh D, Gallacher PJ, Dhaun N. Management of hypertension in chronic kidney disease. Drugs. 2019;79(4):365–79.
33. Pea F. β-Blockers and diltiazem combination—bear in mind the risk of heart block. JAMA Intern Medi. 2017;177(10):1543–4.
34. Kalash A, Abdelrahman A, Al-Zakwani I, Al Suleimani Y. Potentially harmful drug-drug interactions and their associated factors among hospitalized cardiac patients: a cross-sectional study. Drugs Real World Outcomes. 2023;10(3):371–81.
35. Zhang JR, Wang DQ, Du J, et al. Efficacy of clopidogrel and clinical outcome when clopidogrel is coadministered with atorvastatin and lansoprazole: a prospective, randomized, controlled trial. Medicine (Baltimore). 2015;94(50):e2262.
36. Wang ZY, Chen M, Zhu LL, et al. Pharmacokinetic drug interactions with clopidogrel: updated review and risk management in combination therapy. Ther Clin Risk Manag. 2015;11:449–67.
| Files | ||
| Issue | Vol 12, No 2 (Spring 2024) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/jpc.v12i2.16185 | |
| Keywords | ||
| Adverse Effect Medication Error Polypharmacy | ||
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How to Cite
1.
Sari O, Perdana Putra A. Severity and Risk Rating of Drug-Drug Interaction Potency in Chronic Kidney Disease in Public Health Hospital. J Pharm Care. 2024;12(2):78-87.
