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Medication treatment complexity and adherence in children with CKD
Tom D Blydt-Hansen1, Christopher B Pierce, Yi Cai
1Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.
Clinical Journal of the American Society of Nephrology : CJASN
|November 23, 2013
Summary
Managing pediatric chronic kidney disease (CKD) is complex. Increased medication frequency, not the number of conditions, was linked to poorer adherence in children with CKD.
Area of Science:
- Pediatric Nephrology
- Chronic Kidney Disease (CKD) Management
- Comorbidity Assessment
Background:
- Pediatric chronic kidney disease (CKD) management is complicated by numerous comorbid conditions.
- Understanding comorbidity prevalence and clustering is crucial for effective treatment strategies in pediatric CKD.
- Assessing medication use provides insights into comorbidity burden and treatment complexity.
Purpose of the Study:
- To determine the prevalence of comorbidities in pediatric CKD patients.
- To analyze the frequency of co-occurring comorbidities based on medication use.
- To investigate the association between clinical/sociodemographic factors and medication patterns in pediatric CKD.
Main Methods:
- Cross-sectional analysis of the Chronic Kidney Disease in Children study.
- Examined medication use by indication, CKD stage, diagnosis, and patient demographics.
- Assessed nonadherence through self-report of missed medications.
Main Results:
- Medication use for CKD comorbidities increased with advanced CKD stage and glomerular disease.
- Identified three medication clusters: glomerular disease, advanced renal tubular dysfunction, and proteinuric complications.
- Nonadherence was associated with higher medication dosing frequency (>2 times/day), not the number of medications.
Conclusions:
- Medical therapy for pediatric CKD is complex, influenced by diagnosis, CKD stage, and medication frequency.
- CKD staging alone does not reliably predict the need for CKD-related medications.
- Reducing medication frequency, not just the number of conditions, may enhance adherence in pediatric CKD patients.
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