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Self-reported Medication Adherence and CKD Progression

Esteban A Cedillo-Couvert1, Ana C Ricardo1, Jinsong Chen1

  • 1Department of Medicine, University of Illinois at Chicago, Chicago, Ilinois, USA.

Kidney International Reports
|June 2, 2018
PubMed

Insights

Low medication adherence in adults with chronic kidney disease (CKD) is linked to a higher risk of CKD progression. This finding highlights the importance of adherence for managing kidney disease outcomes.

Area of Science:

  • Nephrology
  • Clinical Epidemiology

Background:

  • Medication nonadherence is a significant issue in the general population, leading to adverse health outcomes.
  • Limited data exists on medication adherence patterns and their impact among adults diagnosed with chronic kidney disease (CKD).

Purpose of the Study:

  • To investigate the association between self-reported medication adherence and the progression of CKD.
  • To examine the relationship between medication adherence and all-cause mortality in patients with CKD.

Main Methods:

  • A prospective observational study involving 3305 adults with mild-to-moderate CKD from the Chronic Renal Insufficiency Cohort (CRIC) Study.
  • Baseline medication adherence was self-reported and categorized into high, medium, and low groups.
  • CKD progression (defined as a 50% eGFR decline or ESRD) and all-cause death were analyzed using multivariable Cox proportional hazards models.

Main Results:

  • The majority of participants (68%) reported high medication adherence, with 17% reporting medium and 15% reporting low adherence.
  • Over a median follow-up of 6 years, low adherence was significantly associated with an increased risk of CKD progression (HR=1.27, 95% CI=1.05-1.54) after adjustments.
  • A trend towards increased all-cause mortality risk was observed in the low adherence group (HR=1.14, 95% CI=0.88-1.47), but it did not reach statistical significance.

Conclusions:

  • Low self-reported medication adherence at baseline is a significant predictor of CKD progression in adults with mild-to-moderate CKD.
  • Further research is warranted to elucidate the underlying mechanisms and develop targeted interventions to enhance medication adherence in this patient population.
Abstract

Keywords:
CKDdeathmedication adherenceprogression

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