MI Patients with CKD not taking meds?Darren Triller | January 18, 2011
A recent report in the Clinical Journal of the American Society of Nephrology characterized long and short term adherence to medications typically prescribed after myocardial infarction. Interestingly, adherence to ACE inhibitors and beta blockers was shown to worsen with more advanced stages of CKD (eGFR< 30ml/min/1.73m2).
“Stratifying patients by estimated glomerular filtration rate (eGFR), investigators report that long-term ACE-inhibitor/ARB and beta-blocker use adherence differed by kidney function. Among those in the lowest eGFR category, defined as <30 mL/min/1.73 m2, there was a steeper drop off in medication adherence, with similar findings observed among patients taking beta blockers. There was no difference in long-term adherence to statin therapy in patients with different levels of kidney function.”
The researchers cite several possible contributing factors, including an increased medication burden (i.e. polypharmacy), depression, functional limitations, and cognitive impairment. Clinicians who care for patients with CKD and CAD are therefore encouraged to document CKD status in all patient records and take additional care to promote and continually assess patient adherence to these important medications.
The full details of the study are available at: http://cjasn.asnjournals.org/content/early/by/section