Medication Treatment Complexity and Adherence in Children with CKD

The complexity of CKD management in children is increased by the number of comorbid conditions. This study assessed the prevalence of comorbidities in pediatric CKD and the frequency with which multiple comorbidities present together by assessing prevalent medication use by CKD stage and diagnosis a...

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Bibliographic Details
Published in:Clinical journal of the American Society of Nephrology 2014-02, Vol.9 (2), p.247-254
Main Authors: Blydt-Hansen, Tom D, Pierce, Christopher B, Cai, Yi, Samsonov, Dmitri, Massengill, Susan, Moxey-Mims, Marva, Warady, Bradley A, Furth, Susan L
Format: Article
Language:English
Subjects:
Adolescent
Adolescent Behavior
Age Factors
Child
Child Behavior
Child, Preschool
Cluster Analysis
Comorbidity
Cross-Sectional Studies
Drug Administration Schedule
Female
Glomerular Filtration Rate - drug effects
Health Knowledge, Attitudes, Practice
Humans
Infant
Kidney - drug effects
Kidney - physiopathology
Male
Medication Adherence
Multivariate Analysis
North America - epidemiology
Odds Ratio
Original
Polypharmacy
Prevalence
Prospective Studies
Renal Insufficiency, Chronic - diagnosis
Renal Insufficiency, Chronic - drug therapy
Renal Insufficiency, Chronic - epidemiology
Renal Insufficiency, Chronic - physiopathology
Risk Factors
Severity of Illness Index
Time Factors
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Summary:The complexity of CKD management in children is increased by the number of comorbid conditions. This study assessed the prevalence of comorbidities in pediatric CKD and the frequency with which multiple comorbidities present together by assessing prevalent medication use by CKD stage and diagnosis and their association with clinical or sociodemographic factors. The association between number and frequency of dosing of medications prescribed and self-report of nonadherence was also assessed. In this cross-sectional analysis of the Chronic Kidney Disease in Children study, medication use at study entry grouped by indication was examined by CKD stage, diagnosis, age, race, ethnicity, income, and CKD duration. Multivariate adjusted predictors of medication use and clustering were examined. Nonadherence was assessed by self-report of missed medications in the past 7 days. The 558 eligible participants had a median age of 11 years and median GFR of 44 ml/min per 1.73 m(2); 62% of participants were male and 78% had nonglomerular kidney disease. The number of medications for treatment of CKD comorbidities increased with advanced CKD stage (2.5-fold for stages IV versus II; P
ISSN:1555-9041
1555-905X
DOI:10.2215/CJN.05750513