Banca de QUALIFICAÇÃO: SÁVIO BRUNO ARAÚJO DINIZ

Uma banca de QUALIFICAÇÃO de MESTRADO foi cadastrada pelo programa.
STUDENT : SÁVIO BRUNO ARAÚJO DINIZ
DATE: 03/12/2025
TIME: 15:00
LOCAL: A definir
TITLE:

Drug Interactions in Hemodialysis Patients: A Multicenter Cross-Sectional Study

KEY WORDS:

Drug Interactions, Hemodialysis, Pharmaceutical Care

PAGES: 42
BIG AREA: Ciências da Saúde
AREA: Farmácia
SUBÁREA: Farmácia clínica, assistência e atenção farmacêuticas
SUMMARY:

Introduction: Chronic Kidney Disease is a prevalent condition that, in advanced stages, requires the use of renal replacement therapy, with hemodialysis being common. Patients undergoing hemodialysis therapy use complex pharmacotherapy due to the appearance of comorbidities, thus increasing the likelihood of medication-related problems, one of the main ones being drug interactions. Objective: To evaluate the prevalence of drug interactions in patients with stage 5D chronic kidney disease undergoing chronic outpatient hemodialysis. Methodology: Cross-sectional, prospective, and multicenter study conducted in patients with chronic kidney disease undergoing outpatient hemodialysis, treated in 13 health centers located in 3 capitals of northeastern Brazil, between August 2019 and July 2021. Data were collected through interviews, interactions were analyzed using the UpToDate Lexidrug® platform and the Stata® version 15 program for data analysis. Results: 1,114 patients participated in the study, mostly hypertensive (47.5%) and with an average age of 48.2 years. 328 types of medications were identified in the medication lists, the most frequent being sevelamer (750; 67.3%), with an average of 5.36 (± 2.66) medications per patient. Among the 1,114 patients included, 496 (44.5%) presented a risk of at least one potential drug interaction. According to the risk classification, 792 (81.82%) were risk C. We found 297 pairs of interactions, the most frequent being between calcitriol and sevelamer (144; 14.87%). Through univariate and multivariate modeling (logistic and linear mixed-effects), we found a significant correlation between drug interactions and polypharmacy (OR = 7.98; p < 0.001), age (OR = 1.01; p = 0.025), diabetes (OR = 1.55; p = 0.012), and lupus (OR = 2.73 p = 0.008). Conclusion: This study suggests a high prevalence of potential drug interactions in hemodialysis patients, associated with polypharmacy, advanced age, and the presence of diabetes and lupus. We suggest that deprescribing medications in this population is fundamental, especially vitamin D analogs, which are implicated in a large part of the potential interactions found and do not present robust clinical evidence of benefit for patients with chronic kidney disease on hemodialysis.

COMMITTEE MEMBERS:
Externo à Instituição - DIEGO GNATTA - UFRGS
Presidente - 3315645 - FRANCISCA SUELI MONTE MOREIRA
Interna - 347795 - IVONETE BATISTA DE ARAUJO