| Title: |
Hyperpolypharmacy in patients with chronic kidney disease and its impact on clinical outcomes |
| Authors: |
Mouheb, Agathe; Metzger, Marie; Alencar de Pinho, Natalia; Jacquelinet, Christian; Laville, Maurice; Massy, Ziad; Liabeuf, Sophie; Laville, Solène; Cannet, Dorothée; Combe, Christian; Fouque, Denis; Frimat, Luc; Hamroun, Aghilès; Herpe, Yves-Edouard; Lambert, Oriane; Lange, Céline; Morel, Pascal; Pascal, Christophe; Pecoits-Filho, Roberto; Schantsra, Joost; Stengel, Bénédicte; Hannedouche, T.; Moulin, B.; Klein, A.; Combe, C.; Bourdenx, J.; Keller, A.; Delclaux, C.; Vendrely, B.; Deroure, B.; Lacraz, A.; Lobbedez, T.; Landru, I.; Massy, Z.; Lang, P.; Belenfant, X.; Thervet, E.; Urena, P.; Delahousse, M.; Vela, C.; Essig, M.; Clément, D.; Sekhri, H.; Smati, M.; Jamali, M.; Hacq, B.; Panescu, V.; Bellou, M.; Kamar, N.; Noël, C.; Glowacki, F.; Maisonneuve, N.; Azar, R.; Hoffmann, M.; Hourmant, M.; Testa, A.; Besnier, D.; Choukroun, G.; Lambrey, G.; Burtey, S.; Lebrun, G.; Magnant, E.; Laville, M.; Fouque, D.; Juillard, L.; Chazot, C.; Zaoui, P.; Kuentz, F. |
| Contributors: |
CHU Amiens-Picardie; Mécanismes physiopathologiques et conséquences des calcifications cardiovasculaires - UR UPJV 7517 (MP3CV); Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie; AP-HP. Université Paris Saclay; Centre de recherche en épidémiologie et santé des populations (CESP); Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse; AP-HP. Université Paris Saclay-AP-HP. Université Paris Saclay-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay; Agence de la biomédecine Saint-Denis la Plaine; Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN); Université Claude Bernard Lyon 1 (UCBL); Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE); Hôpital Ambroise Paré AP-HP; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP); Centre Hospitalier Universitaire de Bordeaux (CHU Bordeaux); Université de Bordeaux (UB); Centre Hospitalier Lyon Sud CHU - HCL (CHLS); Hospices Civils de Lyon (HCL); Service de Néphrologie CHRU Nancy; Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy); Service d'Epidémiologie et de Santé Publique Lille; Centre Hospitalier Régional Universitaire CHU Lille (CHRU Lille); Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167 (RID-AGE); Institut Pasteur de Lille; Pasteur Network (Réseau International des Instituts Pasteur)-Pasteur Network (Réseau International des Instituts Pasteur)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire CHU Lille (CHRU Lille); Université Jean Moulin Lyon 3 - Faculté de Droit (UJML3 Droit); Université Jean Moulin - Lyon 3 (UJML); Université de Lyon-Université de Lyon; Centre de recherche en Droit et Management des services de santé (CRDMS); Arbor Research Collaborative for Health; Institut National de la Santé et de la Recherche Médicale (INSERM); Université Paris-Saclay; Hôpitaux Universitaires de Strasbourg (HUS); Service de Néphrologie-Dialyse-Transplantation CHU Amiens-Picardie |
| Source: |
ISSN: 2045-2322. |
| Publisher Information: |
CCSD; Nature Publishing Group |
| Publication Year: |
2026 |
| Collection: |
Université de Versailles Saint-Quentin-en-Yvelines: HAL-UVSQ |
| Subject Terms: |
Hyperpolypharmacy; Chronic kidney disease; Adverse outcomes; [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology |
| Description: |
International audience ; Hyperpolypharmacy (≥ 10 daily medications) is frequent in patients with chronic kidney disease (CKD), but its impact remains poorly characterized. This study, based on 3,011 non-dialyzed, non-transplant CKD outpatients from the CKD-REIN cohort (eGFR < 60 mL/min/1.73 m2) aimed to describe drug burden and assess associations between hyperpolypharmacy and adverse outcomes. Drug prescription, kidney function, adverse drug reactions (ADRs), hospitalizations, kidney replacement therapy and deaths before KRT were prospectively recorded over five years. Median age was 69 years and mean eGFR was 34 mL/min/1.73 m2. At baseline, 80% of the cohort had polypharmacy (≥ 5 daily medications), and 33% had hyperpolypharmacy. These rates remained stable over time. Diabetes, dyslipidemia, and a history of cardiovascular and respiratory diseases were the main contributors to hyperpolypharmacy status. Hyperpolypharmacy was associated with greater likelihoods of an ADR (hazard ratio (HR) [95% confidence interval (CI)] 1.21 [1.04-1.40]), hospitalization (HR [95%CI] 1.34 [1.18-1.51]) and death before KRT (HR [95%CI] 1.46 [1.17-1.82]). Among patients with eGFR ≥ 30 mL/min/1.73m2, hyperpolypharmacy also raised the risk of KRT initiation (HR [95%CI] 1.46 [1.00-2.13]), but not in those with eGFR < 30 (HR [95%CI] 0.94 [0.78-1.14]). These results identify hyperpolypharmacy as a significant concern in CKD and underscore the importance of regular medication reviews to reduce adverse outcomes. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1038/s41598-025-25632-x |
| Availability: |
https://u-picardie.hal.science/hal-05472245; https://doi.org/10.1038/s41598-025-25632-x |
| Accession Number: |
edsbas.DBEFE348 |
| Database: |
BASE |