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Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Aging and antihypertensive medication-related complications in the chronic kidney disease patient

Zachary A Marcum1, Linda F Fried

  • 1Division of Geriatric Medicine, Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA. zam12@pitt.edu

Current Opinion in Nephrology and Hypertension
|June 15, 2011
PubMed

Insights

Older adults with chronic kidney disease (CKD) face risks from antihypertensives, including hyperkalemia, acute kidney injury (AKI), and orthostatic hypotension. Careful monitoring is crucial to prevent adverse drug events (ADEs).

Area of Science:

  • Nephrology
  • Geriatrics
  • Clinical Pharmacology

Background:

  • Older adults with chronic kidney disease (CKD) are a vulnerable population.
  • Antihypertensive medications are frequently prescribed for this group.
  • Limited literature exists on medication errors and adverse drug events (ADEs) in this specific demographic.

Purpose of the Study:

  • To review and describe potential medication errors and ADEs.
  • Focus on antihypertensives used in older adults with CKD.
  • Identify common ADEs and risk factors.

Main Methods:

  • Literature review of recent studies.
  • Analysis of published data on ADEs related to antihypertensives.
  • Synthesis of findings regarding hyperkalemia, AKI, and orthostatic hypotension.

Main Results:

  • Few studies specifically address ADEs in older adults with CKD.
  • Hyperkalemia is associated with ACE inhibitors/ARBs, potassium-sparing diuretics, and beta-blockers.
  • Acute kidney injury (AKI) is often linked to ACE inhibitors/ARBs.
  • Orthostatic hypotension is noted with ACE inhibitors/ARBs, beta-blockers, and calcium-channel blockers.

Conclusions:

  • Common ADEs include hyperkalemia, AKI, and orthostatic hypotension.
  • Consideration of age-related pharmacokinetic/pharmacodynamic profiles is essential.
  • Minimizing risks requires evaluating comorbidities and drug-drug interactions.
  • Diligent monitoring of labs, vitals, and interactions can mitigate ADEs in this high-risk population.
Abstract

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