The Relationship Of Polypharmacy With Glomerular Filtration Rate In Patients With Chronic Kidney Failure: Hubungan Polifarmasi dengan Laju Filtrasi Glomerulus pada Pasien Gagal Ginjal Kronik

Erika Cindiana Pramudia Putri; Primanitha Ria Utami; Irma Susanti

doi:10.53342/pharmasci.v10i2.488

Authors

Erika Cindiana Pramudia Putri Universitas Muhammadiyah Lamongan
Primanitha Ria Utami Universitas Muhammadiyah Lamongan
Irma Susanti Universitas Muhammadiyah Lamongan

DOI:

https://doi.org/10.53342/pharmasci.v10i2.488

Keywords:

Glomerular Filtration,, Chronic Kidney Failure,, Polypharmacy,

Abstract

Polypharmacy is generally used in hemodialysis patients with an average number of drugs given being 14 drugs. In addition to detecting and preventing the severity of renal function, hemodialysis can increase the glomerular filtration rate. This study aims to determine the relationship between polypharmacy and glomerular filtration rate in patients with chronic renal failure at RSUD Dr. Soegiri Lamongan. The research design uses design descriptive with method retrospective with data collection sheet instruments, the population in this study was 174 patients, the sample was selected using techniques purposive sampling By determining the inclusion criteria, 121 patients were obtained. Data analysis using tests Spearman Rho. The results of the number of drug use in chronic kidney failure patients showed that there were more major polypharmacy incidents of ?6 drugs, as many as 115 patients (95.04%). The glomerular filtration rate in patients is mostly in the range <15 ml/minute/1,73 m² as many as 120 patients (99.17%). The results of data analysis show that there is no relationship between polypharmacy and glomerular filtration rate p 0.820. In theory, polypharmacy is related to a decrease in glomerular filtration rate, worsening the patient's condition, resulting in undesirable side effects and drug interactions. Polypharmacy with glomerular filtration rate will result in renal dysfunction and can further exacerbate multimorbidity, so that high levels of comorbidities and chronic inflammation can lead to worse clinical consequences.

References

1. Liyanage, Thaminda, Tadashi Toyama, Carinna Hockham, Toshiharu Ninomiya, Vlado Perkovic, Mark Woodward, Masafumi Fukagawa, Kunihiro Matsushita, Kearkiat Praditpornsilpa, Lai Seong Hooi, Kunitoshi Iseki, Ming Yen Lin, Heide A. Stirnadel-Farrant, Vivekanand and MJ. Prevalence of Chronic Kidney Disease in Asia: A Systematic Review and Analysis. BMJ Glob Heal. 2022;7(1):1–9.

2. Kemenkes RI. Riskesdas 2018. Kementrian Kesehatan RI. Badan Penelitian dan Pengembangan Kesehatan.; 2019.

3. Rahayu, Fitri D. Hubungan Frekuensi Hemodialisa dengan Tingkat Stres pada Pasien Gagal Ginjal Kronik yang Menjalani Hemodialisa. J Keperawatan Silampari. 2018;

4. Lilia, I. H., & Supadmi W. Faktor Risiko Gagal Ginjal Kronik Pada Unit Hemodialisis Rumah Sakit Swasta di Yogyakarta. Maj Farmasetika. 2020;4(1):60–5.

5. Shahzadi A, Sonmez I, Kose C, Oktan B, Alagoz S, Sonmez H, et al. The Prevalence of Potential Drug-Drug Interactions in CKD-A Retrospective Observational Study of Cerrahpasa Nephrology Unit. Med. 2022;58(2):1–10.

6. Pazan F, Wehling M. Polypharmacy in older adults: a narrative review of definitions, epidemiology and consequences. Eur Geriatr Med. 2021;12(3):443–52.

7. Fano V. Estimating the Prevalence and the Determinants of Polypharmacy Using Data from a Health Administrative Database: A Comparison of Results Obtained Employing Different Algorithms. Adv Pharmacoepidemiol Drug Saf. 2014;3(2).

8. Alshamrani M, Almalki A, Qureshi M, Yusuf O, Ismail S. Polypharmacy and Medication-Related Problems in Hemodialysis Patients: A Call for Deprescribing. Pharmacy. 2018;6(3):76.

9. Dipiro. Pharmacotherapy A Phatophysiology Approach, 11th Edition. 11 th. the United States: McGrawa-Hill Education; 2021. 647–693 p.

10. Martono, Satino. Deteksi Keparahan Fungsi Ginjal Melalui Perubahan Kritis Laju Filtrasi Glomerulus Pasien Hemodialisa. J Ners [Internet]. 2014;9(1):43–8. Available from: https://www.researchgate.net/publication/327302069_Deteksi_Keparahan_Fungsi_Ginjal_Melalui_Perubahan_Kritis_Laju_Filtrasi_Glomerulus_Pasien_Hemodialisa_Severity_Renal_Function_Detection_through_Critical_Changes_Glomerular_Filtration_Rate_in_Hemodialys

11. Aisara Sitifa, Syaiful Azmi MY. Gambaran Klinis Penyakit Ginjal Kronik yang Menjalani Hemodialisis di RSUP Dr. M. Djamil Padang. J Kesehat Andalas. 2018;7(1):42–50.

12. Narsa AC, Maulidya V, Reggina D, Andriani W, Rijai HR. Studi Kasus: Pasien Gagal Ginjal Kronis (Stage V) dengan Edema Paru dan Ketidakseimbangan Cairan Elektrolit. J Sains dan Kesehat. 2022;4(SE-1):17–22.

13. Aisya M, Rachmawati H, Hasmono D, Kusumaningtyas AP. The Use of Folic Acid in Chronic Kidney Disease Patients With Anemia. KnE Med. 2022;2022(2018):50–9.

14. Rosdewi, Yuliana T, Mardiana S DT. Pengaruh Hemodialisa terhadap nilai Hemoglobin pada pasien End Stage Renal Disease. J Ners. 2023;7(19):68–73.

15. Sari S, Suhada Z, Triagustini T. Cost of Illness Pasien Gagal Ginjal Kronis di Rumah Sakit Umum Daerah Arifin Achmad Provinsi Riau. J Ilm Farm. 2023;19(2):113–25.

16. Rahmawati F. Aspek Laboratorium Gagal Ginjal Kronik. J Ilm Kedokt Wijaya Kusuma. 2018;6(1):14.

17. Fauziah H, Mulyana R, Martini RD. Polifarmasi Pada Pasien Geriatri. Hum Care J. 2020;5(3):804.

18. Utami P et al. Potensi Interaksi Obat pada Pasien Geriatri yang menggunakan AntiHipertensi di Puskesmas Karanggeneng Lamongan. Media Komun Ilmu Kesehat. 2020;12(02):70–6.

19. Stockley. Stockley’s Drug Interactions (9th ed). London: Pharmaceutical Press; 2010.

20. Probosiwi N, Nur Fama Laili, Tsamrotul Ilmi, Arifani Sisiwidiasari. Analisis Interaksi Obat Yang Potensial Pada Pasien Gagal Ginjal Kronis Dengan Penyakit Penyerta Di Rs. X Kota Kediri. J Inov Farm Indones. 2023;5(1):60–72.

21. Mohtar NJ, Sugeng CEC, Umboh ORH. Penatalaksanaan Anemia pada Penyakit Ginjal Kronik. e-CliniC. 2023;11(1):51–8.

22. Richard S. Divisions Of Nephrology & Hypertension And General Internal Medicine Edition 6.0. 2011. 19–21 p.

23. Xie X, Liu Y, Perkovic V, Li X, Ninomiya T, Hou W, et al. Renin-Angiotensin System Inhibitors and Kidney and Cardiovascular Outcomes in Patients with CKD: A Bayesian Network Meta-analysis of Randomized Clinical Trials. Am J Kidney Dis [Internet]. 2016;67(5):728–41. Available from: http://dx.doi.org/10.1053/j.ajkd.2015.10.011

24. Fandinata SS, Darmawan R, Utami PR, Ulfa NM. Monitoring Kidney Function Through the Use of Candesartan, Telmisartan or Valsartan Antihypertensive Therapy towards Patients CKD. Media Kesehat Masy Indones. 2022;18(1):1–9.

25. Malek R SS. Pulmonary Edema [Internet]. 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557611/ StatPearls.

26. Zanza C, Saglietti F, Tesauro M, Longhitano Y, Savioli G, Balzanelli MG, et al. Cardiogenic Pulmonary Edema in Emergency Medicine. Adv Respir Med. 2023;91(5):445–63.

27. Aipassa I, Rahayu M, Ariyadi T. Perbedaan Kadar Ureum Serum Dan Plasma Lithium Heparin. J Labora Med. 2020;4(3):42–6.

28. Muti AF, Chasanah U. Evaluasi Rasionalitas Penggunaan Diuretik pada Pasien Gagal Ginjal Kronik yang Dirawat Inap di RSUD Dr. Saiful Anwar Malang. Sainstech Farma [Internet]. 2016;9(2):23–31. Available from: https://ejournal.istn.ac.id/index.php/saintechfarma/article/download/79/57/

29. Wang X, Yang C, Jiang J, Hu Y, Hao Y, Dong JY. Polypharmacy, Chronic Kidney Disease, and Mortality Among Older Adults: A Prospective Study of National Health and Nutrition Examination Survey, 1999–2018. Front Public Heal. 2023;11(March):1–9.

30. De Lima JJG, Gowdak LHW, David-Neto E B LA. Diabetes, Cardiovascular Disease, and Cardiovascular Risk in patients with Chronic Kidney Disease. High Blood Press Cardiovasc Prev. 2021;28:159–65.

31. Salimi S, Shardell MD, Seliger SL, Bandinelli S, Guralnik JM FL. Inflammation and trajectory of renal function in community-dwelling older adults. J Am Geriatr Soc. 2018;66:804–11.