Factors associated with medication-related problems in ambulatory hemodialysis patients

Am J Kidney Dis. 2003 Feb;41(2):386-93. doi: 10.1053/ajkd.2003.50048.


Background: Hemodialysis (HD) patients are at risk for medication-related problems. Patient characteristics associated with the number of medication-related problems in HD patients have not been investigated.

Methods: Patient records were reviewed to identify medical problems, prescribed medications, medication indication(s), and medication-related problems. Medication classes and medication-related problems were compared between patients with and without diabetes mellitus (DM). Correlations were performed to determine whether associations exist between medication-related problems, number of medications, number of medication doses per day, number of comorbid conditions, patient age, and duration of end-stage renal disease while controlling for DM status.

Results: Medical records of 133 patients were evaluated. Patients were 60.5 +/- 15.2 years old, prescribed 11.0 +/- 4.2 medications, and had 6.0 +/- 2.3 comorbidities. Medication-related problems were identified in 97.7% of patients. Four hundred seventy-five medication-related problems were identified, averaging 3.6 +/- 1.8 medication-related problems per patient. Patients with DM had more medication-related problems identified than those without DM (303 versus 172 medication-related problems, respectively; P < 0.05). Medication-related problems correlated positively with number of patient comorbidities (P < 0.001).

Conclusion: Medication-related problems are prevalent in virtually all HD patients. The number of medication-related problems in an individual patient increases as the number of comorbid conditions increases. The most frequent medication-related problems were drug without indication (30.9%), laboratory (27.6%), indication without drug use (17.5%), and dosing errors (15.4%). Patients with DM are at increased risk for medication-related problems. Health care providers taking care of HD patients should be aware of this problem, and efforts to avoid or resolve medication-related problems should be undertaken at all HD clinics.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Anemia / complications
  • Anemia / drug therapy
  • Cardiovascular Diseases / complications
  • Cardiovascular Diseases / drug therapy
  • Diabetes Complications
  • Diabetes Mellitus / drug therapy
  • Female
  • Gastrointestinal Diseases / complications
  • Gastrointestinal Diseases / drug therapy
  • Humans
  • Infections / complications
  • Infections / drug therapy
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / therapy
  • Male
  • Medication Errors / statistics & numerical data
  • Medication Errors / trends*
  • Mental Disorders / complications
  • Mental Disorders / drug therapy
  • Middle Aged
  • Pain / complications
  • Pain / drug therapy
  • Peritoneal Dialysis, Continuous Ambulatory / methods
  • Peritoneal Dialysis, Continuous Ambulatory / trends*
  • Pruritus / complications
  • Pruritus / drug therapy
  • Retrospective Studies
  • Risk Factors