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Abstract

The prevalence of chronic kidney disease (CKD) in Indonesia has increased from 2.0 ‰in 2013 to 3.8 ‰in 2018. The presence of complex comorbidities associated with CKD causes varied therapy regimens (poly-pharmacy), leading to an increased risk of drug-related problems (DRPs). To overcome these complications, dialysis is often used to remove metabolic waste and rebalance electrolytes to maintain life in patients experiencing rapid loss of kidney function. This study aims to evaluate drugs consumed as well as DRPs experienced by patients diagnosed with CKD undergoing hemodialysis at X Hospital from January to May 2022. The study procedures were carried out using a retrospective cross-sectional method by exploring medical record data of 15 CKD patients with comorbidities aged 20 – 80 years, receiving regular treatment, receiving 2 or more types of medication and undergoing hemodialysis from January to May 2022. Subsequently, the data obtained were presented as frequencies in tabular form, and DRPs were assessed using the Medscape drug interaction checker application. In the DRPs domain (Domain P2.1), common issues included drugs prescribed without clear indications (Domain C1.3) and untreated indications (Domain P1.3). Inappropriate drug selection (Domain P1.2) was also identified as a significant concern. However, there were no problems with inappropriate dose selection (Domain C3.1) or patients who failed to receive the drugs due to inappropriate dosage forms (Domain C2.1). The incidence of DRPs was divided into various categories, including drugs without indications (46.67%), inappropriate drug selection (20%), and drug interactions (66.67%). The results also showed the presence of a case of major pharmacodynamic interaction, 6 cases of moderate interaction, 6 cases of moderate pharmacokinetic interaction, 5 cases of unknown type of interaction, and 20 cases of minor interaction. The prevalence of DRPs was notably high among patients, resulting in actual or potential adverse drug events (ADEs). Additionally, there was a risk of suboptimal pharmacotherapy outcomes due to the potential lack of therapeutic effect.

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