Drug treatment in non-dialysed chronic renal failure patients in senegal (west africa)

Abstract

Introduction: In Senegal the drug prescription in chronic renal failure patients (CRF) is not well appreciated. The objectives of this study were to analyze drug prescription in patients with non-dialysis CRF, the factors’ progression for chronic renal disease (CKD) and occurrence of death related to drug prescription. Patients and Methods: It was a retrospective, descriptive and analytical study carried out in the nephrology department of the LEDANTEC hospital in Dakar from January 1st, 2015 to December 31st, 2015. Were included any patient received in consultation or hospitalization with a CKD from Stage 3 and not dialyzed. Results: The hospital prevalence was 6.06%. The average age was 56.19 ± 15.17 years. The high blood pressure (HBP) was found in 138 patients (81.66%) and 65 patients (47.10%) did not have a precise treatment. Forty- seven patients (28%) were diabetic and 9 badly followed-up. General signs such as paleness of mucosa (57.14%) and lower limbs edema (52%) were in the foreground while digestive (7.69%) and neurological (7.10%) signs were poorly represented. Therapeutically, a total of 65 drugs were prescribed and amlodipine was the most prescribed at 16.31%. Forty-nine patients (28.99%) had at least one drug contraindicated. The Acetylsalicylic acid was the most prescribed contraindicated drug 31 times or 52.54%. One hundred and three patients, or 60.95%, had at least one drug poorly adapted to renal function, and antihypertensives took over 90.91% of these inappropriate prescriptions. No maladaptation was related to the chronic renal disease development, but the contraindicated drugs had an influence on the death of the patients with a p at 0.015. Conclusion: Our study shows that drugs contraindicated and poorly adapted to renal function are recurrently prescribed in non-dialyzed CRF. A use of the Prescription Guides and Kidney (GPR) recommendations before any prescription in the renal failure could improve the treatment in our structures