March 5, 2014
CKD Patients Frequently Have Adverse Effects From Treatment

Baltimore, MD—The treatment may not be worse than the disease for chronic kidney disease (CKD) patients, but it certainly can present a unique set of challenges.

A new study published online by the Journal of the American Society of Nephrology (JASN) finds that low blood sugar and high blood potassium are common complications of treatment. The research, led by University of Maryland scientists, suggests that patients with CKD are more susceptible to adverse side effects because of impaired kidney function and the complexity of the drug regimens to treat the disease, even in outpatient settings.

For the study, researchers looked for patient-reported adverse safety incidents—either class I or II—in 267 CKD patients enrolled in the ongoing Safe Kidney Care study, which is attempting to determine the frequency of complications of medical care with outpatient treatment of CKD patients.

The class I safety incidents are reported hazardous events or symptoms that study participants attribute to a medication. Class II actionable safety findings are hazardous clinical disturbances detected at study evaluations that have the potential to be corrected with treatment or medication modification.

Researchers found that 185 patients (69.3%) had at least one class I or II event, 102 (38.2%) had more than one event, and 48 (18.0%) had at least one event from both classes. Hypoglycemia was the most common class I event, while hyperkalemia was the most common adverse reaction in the class II category.

The adjusted conditional rates of class I and class II events ranged from 2.9 to 57.6 per 100 patients and from 2.2 to 8.3 per 100 patients, respectively, according to the study.

Hypoglycemia in patients with diabetes or falling/severe dizziness in patients without diabetes often were seen in conjunction with other complications of medical care, the report notes.

“Disease-specific adverse safety events are strikingly common in CKD and in the setting of medications that can account for such events. It is possible that efforts to prevent these unintended events will reduce the rate of renal function loss and poor outcomes in patients with CKD,” said corresponding author Jeffrey Fink, MD.

The authors call for more research “to define the CKD ‘safety phenotype’ and identify patients at highest risk for adverse safety events.”

U.S. Pharmacist Social Connect