Evaluation Of Chronic Kidney Disease And Medication Prescribing Patterns In A Single Tertiary Care Center In Malaysia

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dc.contributor.authorSALMAN, MUHAMMAD
dc.date.accessioned2016-05-11T07:36:46Z
dc.date.available2016-05-11T07:36:46Z
dc.date.issued2015-01
dc.description.abstractChronic kidney disease (CKD) is an escalating medical problem worldwide, effecting socioeconomic conditions of patient’s family and country, and information about its etiologies and medication prescribing patterns, needed to improve a better clinical outcome, is sparse in Malaysia. Therefore, this study is intended to evaluate the etiologies of CKD and medication use in Malaysian patients suffering from CKD. A retrospective, cross-sectional study was conducted on adult CKD patients, receiving treatment at Hospital Universiti Sains Malaysia, Kelantan, Malaysia from 1st January 2009 to 31st December 2013. Data regarding patient socio-demographics, laboratory investigations, etiology, stage of CKD and medications were collected. Individual drugs were classified according to the Anatomical Therapeutic Chemical Classification as recommended by the World Health Organization (WHO). Comparison was made between age groups (≤ 50 or > 50 years), gender, diabetic status and CKD stages. A total of 851 eligible cases were included with male to female ratio of 1.75: 1.00 and mean age of 61.18 ± 13.37 years. CKD stage 5 was accounted in 333 (39.1%) cases whereas stage 4, 3b, 3a and 2 cases were 240 (28.2%), 186 (21.9%), 74 (8.7%) and 18 (2.1%), respectively. In the sample population, diabetic nephropathy (DN) (44.9%) was found to be the foremost etiology of CKD, followed by hypertension (HPT) (24.2%) and obstructive uropathy (OBS) (9.2%). Unknown etiology constituted 9.4% of our cases. The difference of incidence of CKD due to DN, HPT, GN, patients of age ≤ 50 years and patients of age > 50 years was statistically significant (P = 0.008, P < 0.001 and P < 0.001, respectively). Patients were prescribed 12.10 ± 4.68 medications. The top five prescribed xv medication groups were found to be lipid lowering agents, calcium channel blockers, antiplatelet agents, diuretics and drugs for acid related disorders. Underutilization of several classes of medications was apparent. Patient age and gender did not influence the number of medications used (P = 0.09 and P = 0.40, respectively). Diabetic patients were prescribed more drugs than patients without DM (13.96 ± 4.78 vs 10.71 ± 3.60 p = 0.001). Moreover, the number of prescribed medications significantly increased with declining renal function with a hierarchy (stage 2 and 3a < stage 3b < stage 4 < stage 5ND < stage 5D). The results of the present study indicate that diabetic nephropathy is the chief cause of CKD followed by hypertension. This study also provides an overview of medication use in a Malaysian CKD population. Underutilization of some medication classes is apparent and instructive efforts in this direction may ascertain better outcomes.en_US
dc.identifier.urihttp://hdl.handle.net/123456789/2031
dc.subjectEvaluation Of Chronic Kidney Disease And Medication Prescribing Patternsen_US
dc.subjectIn A Single Tertiary Care Center In Malaysiaen_US
dc.titleEvaluation Of Chronic Kidney Disease And Medication Prescribing Patterns In A Single Tertiary Care Center In Malaysiaen_US
dc.typeThesisen_US
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