The use of nephrotoxic drugs in patients with chronic kidney disease

Background The use of nephrotoxic drugs has the potential to accelerate the loss of kidney function and increase the risk of end-stage renal disease. Objectives To determine the prevalence of nephrotoxic drugs use in patients with chronic kidney disease at two major hospitals in Maiduguri and to evaluate the predictors of exposure to the contraindicated ones. Methods This retrospective study used data from the patients' medical records. Patients aged ≥ 18 years that were diagnosed with chronic kidney disease from 2013 to 2017 with documented serum creatinine levels for the period under review were included in the study. Descriptive statistics were used to summarize the socio-demographics, clinical and biochemical characteristics of the study population. Predictors of nephrotoxic, and contraindicated nephrotoxic medication exposure were assessed using Chi square and logistic regression tests respectively. Results The results are based on data from 201 patients. Of these, 96.0% received at least one prescription of a nephrotoxic drug within the period under review. Multivariate logistic regression showed that the odds of receiving the seven contraindicated nephrotoxic drugs increased in those aged 60 years or older (OR 8.00, 95% CI 1.67-38.40), and those with mild/moderate chronic kidney disease (OR 3.51, 95% CI 1.14-10.77). Main Outcome Measure Prevalence of nephrotoxic drug exposure in patients with chronic kidney disease. Conclusions Large proportions of patients with chronic kidney disease received nephrotoxic drugs, mainly diuretics. However, patients aged 60 years or older, and those at chronic kidney disease stages 2-3 were significantly more likely to receive contraindicated nephrotoxic drugs compared to other age groups and chronic kidney disease stages.