Doctors are prescribing toxic drug to children with Chronic Kidney Disease?

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Chronic Kidney Disease

An analysis of records from primary care practices in the United Kingdom found that many children with Chronic Kidney Disease are receiving prescriptions toxic to their kidneys.

Researchers from the University of Montreal analyzed the 1997–2017 data on children who received medication from general primary care practices in the United Kingdom, found out that 71 percent of children with chronic kidney disease (CKD) received medication that are toxic to the kidney.

The study entitled “Primary Care Prescriptions of Potentially Nephrotoxic Medications in Children with Chronic Kidney Disease,” launched to determine whether the medications prescribed by the physicians are necessary and appropriate, or if alternatives could be prescribed instead.

In this study the researchers labeled medications as Category A (consistently recognized as toxic to the kidneys) and Category B (recognized as potentially toxic to the kidneys).

The analysis includes 1,018 patients with newly diagnosed Chronic Kidney Disease, and 4,072 patients without Chronic Kidney Disease. With an average follow-up of 3.3 years.

Results showed that 26% of patients (children with chronic kidney disease) and 15% of patients without CKD were prescribed one or more Category A medications.

When considering Category B medications (which include Category A medications), 71% of patients with CKD and 50% of patients without CKD received at least one medication during follow-up.

The rate of Class A prescriptions was 71 per 100 person-years and 8 per 100 person-years in CKD and non-CKD patients, respectively.

A person-year is the number of years of follow-up multiplied by the number of people in the analysis.

The respective rates of Class B prescriptions were 278 vs. 44 per 100 person-years.

Analyses revealed that children with chronic kidney disease were prescribed medications that were potentially toxic to the kidneys at a rate that was 4-times higher than in children with chronic kidney disease.

“We found that medications that are potentially toxic to the kidney are prescribed at high rates to children with kidney disease,” said Dr. Claire Lefebvre (MDCM) of Canadian Institute of Health Research (CIHR).

“We hope that this research result will encourage future studies evaluating the reasons for these high rates and, eventually result to the development of clinical decision support systems and physician education programs to reduce inappropriate nephrotoxic medication prescribing in children with chronic kidney disease.”

Co-authors of this study include Kristian B. Filion PhD, Pauline Reynier, Robert W. Platt PhD, and Michael Zappitelli MD, MSc.

The result of this study is published at American Society of Nephrology (ASN) | December 12, 2019, doi: 10.2215/CJN.03550319.

For more information, please visit www.asn-online.org or contact the society at 202-640-4660.