[Descriptive study of drug consumption, polypharmacy, and nutritional risk in patients undergoing periodic...

Background and objective: polypharmacy is prevalent among patients undergoing hemodialysis (HD). This study aimed to determine the prevalence of polypharmacy and to define drug consumption according to pharmacotherapeutic classification, as well as to assess its association with clinical and nutritional outcomes in HD patients. Patients and methods: a cross-sectional, retrospective study in 96 prevalent patients on HD over a two-year period. Sociodemographic, clinical, nutritional, and laboratory data, as well as drug consumption, were collected. Polypharmacy was defined as the use of ≥ 4 drugs/day. Protein-energy wasting syndrome (PEW) was assessed using the malnutrition-inflammation score (MIS ≥ 5), and comorbidity was evaluated with the Charlson Comorbidity Index (CCI). Results: the prevalence of polypharmacy was 60.4 % (n = 58). Patients with polypharmacy had a higher body mass index and transferrin saturation but lower serum creatinine and HDL-cholesterol levels compared to those with low drug consumption (p < 0.05). Additionally, patients with polypharmacy had higher PEW and CCI score (> 3 points). Overall, the most used medications were intravenous iron-sucrose (90.6 %), erythropoiesis-stimulating agents (65.6 %), antihypertensives (58.0 %), and vitamin D (43.7 %). PEW was present in 34.8 % of patients, with a higher prevalence in the polypharmacy group (21.7 %). Conclusions: polypharmacy is highly prevalent among older adults on HD and is associated with higher comorbidity and nutritional risk. These findings highlight the need for a comprehensive and interdisciplinary approach to optimize the rational use of medications and improve the management of pluripathological patients undergoing HD.