Older US adults bear a substantial burden of chronic disease and take an average of five prescription and non-prescription medications per day. Recent data suggest that over 20% of older adults have chronic kidney disease (CKD) as defined by an impaired glomerular filtration rate. These individuals often have multiple comorbidities, including diabetes, hypertension, and cardiovascular disease. Although patients with CKD may receive substantial benefits from prescribed medications, they are also at high risk for adverse drug events and polypharmacy. In this review, we outline the risks and benefits of medication use in the CKD population as a specific case within geriatric pharmacoepidemiology as a framework.
∗Divisions of Nephrology and Family and Preventive Medicine, Veterans' Affairs Medical Center, San Diego, and the University of California, San Diego, CA
†Division of Nephrology, Stanford University School of Medicine, Palo Alto, CA
Address correspondence to Wolfgang C. Winkelmayer, MD, ScD, Division of Nephrology, Stanford University School of Medicine, 780 Welch Rd, Ste 106, Palo Alto, CA 94304.
Dr. Rifkin has nothing to disclose; Dr. Winkelmayer's recent support includes a Scientist Development Grant from the American Heart Association, a Norman S. Coplon Extramural Research Program Award from Satellite Healthcare, Inc., support from the National Institutes of Health, and investigator-initiated grants from Amgen and GlaxoSmithKline. In the last 3 years, he has participated in advisory boards or been a consultant to AMAG Pharmaceuticals, Amgen, Fibrogen, and Fresenius, MD, MPH, ScD, FASN.
ABSTRACT