{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T10:03:35Z","timestamp":1790417015190,"version":"4.1.0"},"reference-count":49,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2021,7,6]],"date-time":"2021-07-06T00:00:00Z","timestamp":1625529600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002997","name":"Dutch Kidney Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002997","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,12,21]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n This study aims to examine polypharmacy (PP) prevalence in patients with chronic kidney disease (CKD) Stage G4\/G5 and patients with kidney replacement therapy (KRT) compared with matched controls from the general population. Furthermore, we examine risk factors for PP and describe the most commonly dispensed medications.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Dutch health claims data were used to identify three patient groups: CKD Stage G4\/G5, dialysis and kidney transplant patients. Each patient was matched to two controls based on age, sex and socio-economic status (SES) score. We differentiated between \u2018all medication use\u2019 and \u2018chronic medication use\u2019. PP was defined at three levels: use of \u22655 medications (PP), \u226510 medications [excessive PP (EPP)] and \u226515 medications [hyper PP (HPP)].<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The PP prevalence for all medication use was 87, 93 and 95% in CKD Stage G4\/G5, dialysis and kidney transplant patients, respectively. For chronic medication use, this was 66, 70 and 75%, respectively. PP and comorbidity prevalence were higher in patients than in controls. EPP was 42 times more common in young CKD Stage G4\/G5 patients (ages 20\u201344\u2009years) than in controls, while this ratio was 3.8 in patients \u226575\u2009years. Older age (64\u201375 and \u226575\u2009years) was a risk factor for PP in CKD Stage G4\/G5 and kidney transplant patients. Dialysis patients \u226575\u2009years of age had a lower risk of PP compared with their younger counterparts. Additional risk factors in all patients were low SES, diabetes mellitus, vascular disease, hospitalization and an emergency room visit. The most commonly dispensed medications were proton pump inhibitors (PPIs) and statins.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n CKD Stage G4\/G5 patients and patients on KRT have a high medication burden, far beyond that of individuals from the general population, as a result of their kidney disease and a large burden of comorbidities. A critical approach to medication prescription in general, and of specific medications like PPIs and statins (in the dialysis population), could be a first step towards more appropriate medication use.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/ckj\/sfab120","type":"journal-article","created":{"date-parts":[[2021,6,28]],"date-time":"2021-06-28T15:21:18Z","timestamp":1624893678000},"page":"2497-2523","source":"Crossref","is-referenced-by-count":45,"title":["Polypharmacy and medication use in patients with chronic kidney disease with and without kidney replacement therapy compared to matched controls"],"prefix":"10.1093","volume":"14","author":[{"given":"Manon J M","family":"van Oosten","sequence":"first","affiliation":[{"name":"Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan J J","family":"Logtenberg","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Diakonessenhuis, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc H","family":"Hemmelder","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Maastricht University Medical Center, The Netherlands"},{"name":"Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martijn J H","family":"Leegte","sequence":"additional","affiliation":[{"name":"Dutch Renal Registry, Nefrovisie Foundation, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henk J G","family":"Bilo","sequence":"additional","affiliation":[{"name":"Diabetes Research Center and Department of Epidemiology and Statistics, Isala Hospital, Zwolle, The Netherlands"},{"name":"Department of Internal Medicine, University Medical Center, Groningen, The Netherlands"},{"name":"Faculty of Medicine, Groningen University, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kitty J","family":"Jager","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vianda S","family":"Stel","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,7,6]]},"reference":[{"key":"2021122112464270700_sfab120-B1","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1002\/pds.966","article-title":"Three 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