{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T01:36:49Z","timestamp":1789609009630,"version":"build-2803163510"},"reference-count":42,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Basic Clin Pharma Tox"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Medication burden in older patients with chronic kidney disease (CKD) is substantial, and simple medication counts are insufficient for identifying those at elevated risk of inappropriate prescribing. This study characterized medication burden by assessing the number of medications, potentially inappropriate medications (PIMs) and anticholinergic burden in dialysis and non\u2010dialysis patients with CKD aged \u2265\u200965\u2009years. This retrospective study included patients with a CKD diagnosis who had hospital contact at the Department of Nephrology, Aalborg University Hospital, Denmark, between January and December 2022. Patients were classified as receiving dialysis or not, and polypharmacy and hyper\u2010polypharmacy were defined as \u2265\u20095 and \u2265\u200910 medications, respectively. PIMs were identified using the EU(7)\u2010PIM list, and anticholinergic burden was evaluated using the ACB scale with a cut\u2010off of \u2265\u20093 points. In total, 140 dialysis patients and 534 non\u2010dialysis patients were included. Polypharmacy was present in all dialysis patients and in 83% of non\u2010dialysis patients, whereas hyper\u2010polypharmacy affected 89% and 56%, respectively. Dialysis patients had a higher median number of PIMs (3 vs. 2) and a greater proportion with an ACB score\u2009\u2265\u20093 (44% vs. 27%). Proton pump inhibitors (PPIs), opioids and non\u2010benzodiazepine hypnotics (Z\u2010drugs) were identified as common PIMs, whereas bladder antimuscarinics (tolterodine and solifenacin), sedating antihistamines (clemastine and promethazine) and antipsychotics with anticholinergic properties (quetiapine) were the most frequently used medications with strong anticholinergic properties. In conclusion, medication burden in patients with CKD is high, and incorporating PIMs and ACB scores may identify prescribing risks not captured by medication counts alone.<\/jats:p>","DOI":"10.1111\/bcpt.70260","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T11:47:20Z","timestamp":1782906440000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Medication Burden: Beyond Counts to Recognize Polypharmacy as an Inherent Part of Living With Chronic Kidney Disease"],"prefix":"10.1111","volume":"139","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4058-3012","authenticated-orcid":false,"given":"Morten Baltzer","family":"Houlind","sequence":"first","affiliation":[{"name":"Department of Clinical Research Copenhagen University Hospital, Amager and Hvidovre  Hvidovre Denmark"},{"name":"Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"},{"name":"Department of Nephrology and Endocrinology Copenhagen University Hospital Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helle Gybel","family":"Juul\u2010Larsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Research Copenhagen University Hospital, Amager and Hvidovre  Hvidovre Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Strandhave","sequence":"additional","affiliation":[{"name":"Department of Nephrology Aalborg University Hospital  Aalborg Denmark"},{"name":"Department of Clinical Medicine, The Faculty of Medicine Aalborg University  Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2663-8040","authenticated-orcid":false,"given":"Niels","family":"Westergaard","sequence":"additional","affiliation":[{"name":"Centre for Health University College Absalon  Roskilde Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9365-1918","authenticated-orcid":false,"given":"Anne Estrup","family":"Olesen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, The Faculty of Medicine Aalborg University  Aalborg Denmark"},{"name":"Department of Clinical Pharmacology Aalborg University Hospital  Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877\u2010020\u20101485\u20104"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kisu.2021.11.003"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfab120"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877\u2010017\u20100621\u20102"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2023.1122898"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2021.734045"},{"key":"e_1_2_11_8_1","first-page":"1","volume-title":"World Health Organization Technical Report; Medication Safety in Polypharmacy. 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