engleski

Side Effects of Antihypertensive and Anticoagulant Medication in Chronic Kidney Disease

Background: The metabolism of many drugs depends on kidney function, but chronic kidney disease (CKD) is still recognized in a very small number of patients. Objectives: To determine whether side effects of antihypertensive and anticoagulant drugs are more common in patients with CKD and whether they depend on the age and gender of the patient. Methods: 455 patients (295 women, 160 men) examined in the emergency clinic of the Clinical Hospital Merkur were analyzed. Medication, side effects, and urgent laboratory findings were recorded. Renal function was calculated with the CKD-EPI formula (KDIGO 2020), and patients were divided into groups with and without CKD and separated according to the side effect cause. Student`s t-test, chi-square test, and descriptive statistics were used in data processing in Statistica v.12. Results: Side effects of antihypertensive and anticoagulant drugs were found in 275 patients (59.14%) with an average age of 72.9 years without differences between genders. CKD was present in 151 patients (54.91%), more commonly in men (68.94% vs. 42.80% in women ; p0.001 ; kidney function: 48.77 vs. 63.61 ml/min/1.73m2 in women ; p0.001). The most common cause of side effects were anticoagulants (45.09% warfarin, 16.00% NOAC), in whose users 66.94% of patients had CKD, while antihypertensives were dominated by ACE inhibitors (28.00%), of which 31.17% of patients had CKD. Calcium channel blockers caused 7.64% of side effects (CKD had 42.86%), and diuretics 3.27% (CKD had 77.78%). The most common side effect was bleeding (68.14% of patients), while dry cough, leg edema, angioedema, and hyperkalemia were found in 18.72%, 7.64%, 3.58%, and 1.12%, respectively. Conclusion: Anticoagulant drugs caused the greatest number of side effects (most often bleeding) and are more significantly associated with the existence of CKD compared to antihypertensives, which more often caused side effects in patients without CKD (dry cough, leg edema, angioedema, and hypokalemia).

Anticoagulant therapy ; Chronic kidney disease ; Drug side-effects

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