{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T20:30:50Z","timestamp":1790281850448,"version":"4.1.0"},"reference-count":47,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2019,5,25]],"date-time":"2019-05-25T00:00:00Z","timestamp":1558742400000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"German Ministry of Education and Research","award":["FKZ 01ER 0804"],"award-info":[{"award-number":["FKZ 01ER 0804"]}]},{"name":"German Ministry of Education and Research","award":["01ER 0818"],"award-info":[{"award-number":["01ER 0818"]}]},{"name":"German Ministry of Education and Research","award":["01ER 0819"],"award-info":[{"award-number":["01ER 0819"]}]},{"name":"German Ministry of Education and Research","award":["01ER 0820"],"award-info":[{"award-number":["01ER 0820"]}]},{"name":"German Ministry of Education and Research","award":["01ER 0821"],"award-info":[{"award-number":["01ER 0821"]}]},{"name":"KfH Foundation for Preventive Medicine"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Patients with chronic kidney disease (CKD) bear a substantial burden of comorbidities leading to the prescription of multiple drugs and a risk of polypharmacy. However, data on medication use in this population are scarce.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A total of 5217 adults with an estimated glomerular filtration rate (eGFR) between 30 and 60\u2009mL\/min\/1.73\u00a0m2 or an eGFR \u226560\u2009mL\/min\/1.73m2 and overt proteinuria (&gt;500\u2009mg\/day) were studied. Self-reported data on current medication use were assessed at baseline (2010\u201312) and after 4\u2009years of follow-up (FU). Prevalence and risk factors associated with polypharmacy (defined as the regular use of five or more drugs per day) as well as initiation or termination of polypharmacy were evaluated using multivariable logistic regression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The prevalence of polypharmacy at baseline and FU was almost 80%, ranging from 62% in patients with CKD Stage G1 to 86% in those with CKD Stage G3b. The median number of different medications taken per day was eight (range 0\u201327). \u03b2-blockers, angiotensin-converting enzyme inhibitors and statins were most frequently used. Increasing CKD G stage, age and body mass index, diabetes mellitus, cardiovascular disease and a history of smoking were significantly associated with both the prevalence of polypharmacy and its maintenance during FU. Diabetes mellitus was also significantly associated with the initiation of polypharmacy [odds ratio (OR) 2.46, (95% confidence interval 1.36\u20134.45); P\u2009=\u20090.003].<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Medication burden in CKD patients is high. Further research appears warranted to address the implications of polypharmacy, risks of drug interactions and strategies for risk reduction in this vulnerable patient population.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ckj\/sfz046","type":"journal-article","created":{"date-parts":[[2019,3,27]],"date-time":"2019-03-27T18:24:02Z","timestamp":1553711042000},"page":"663-672","source":"Crossref","is-referenced-by-count":121,"title":["Patterns of medication use and the burden of polypharmacy in patients with chronic kidney disease: the German Chronic Kidney Disease study"],"prefix":"10.1093","volume":"12","author":[{"given":"Insa M","family":"Schmidt","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacology and Toxicology, Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"H\u00fcbner","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension, Friedrich-Alexander Universit\u00e4t Erlangen-N\u00fcrnberg, Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Nadal","sequence":"additional","affiliation":[{"name":"Department of Medical Biometry, Informatics, and Epidemiology, University Hospital, Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Titze","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension, Friedrich-Alexander Universit\u00e4t Erlangen-N\u00fcrnberg, Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Schmid","sequence":"additional","affiliation":[{"name":"Department of Medical Biometry, Informatics, and Epidemiology, University Hospital, Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"B\u00e4rthlein","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics, Friedrich-Alexander Universit\u00e4t Erlangen-N\u00fcrnberg, Erlangen, Germany"},{"name":"Medical Centre for Information and Communication Technology, University Hospital Erlangen, Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6050-5842","authenticated-orcid":false,"given":"Georg","family":"Schlieper","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Dienemann","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension, Friedrich-Alexander Universit\u00e4t Erlangen-N\u00fcrnberg, Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulla T","family":"Schultheiss","sequence":"additional","affiliation":[{"name":"Institute of Genetic Epidemiology, Faculty of Medicine and Medical Center-University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heike","family":"Meiselbach","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension, Friedrich-Alexander Universit\u00e4t Erlangen-N\u00fcrnberg, Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"K\u00f6ttgen","sequence":"additional","affiliation":[{"name":"Institute of Genetic Epidemiology, Faculty of Medicine and Medical Center-University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Fl\u00f6ge","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Busch","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, University Hospital Jena, Jena, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reinhold","family":"Kreutz","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology and Toxicology, Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8110-9064","authenticated-orcid":false,"given":"Jan T","family":"Kielstein","sequence":"additional","affiliation":[{"name":"Medical Clinic V \u2013 Nephrology, Rheumatology, Blood Purification, Academic Teaching Hospital Braunschweig, Braunschweig, 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