Management of asymptomatic hyperuricemia and assessment of drug-drug interactions in patients with chronic kidney diseases

The prevalance of chronic kidney disease (CKD) has been increased rapidly in the world. The aim of this study was to evaluate the management of asymptomatic hyperuricemia and drug-drug interactions in patients with CKD. In addition, within the scope of the study, it was aimed to determine the risk of progression in patients with CKD and to evaluate patients' health-related quality of life by involvement of a clinical pharmacist. The study was conducted as prospective, cross-sectional (January 2021 – October 2021) at the outpatient clinic of Hacettepe University Faculty of Medicine, Department of Internal Medicine, Department of Nephrology. Ninety-one patients were included in the study. It was observed that in patients with asymptomatic hyperuricemia, drug therapy was initiated when uric acid level was 9.11 (±1.41) mg/dl. Allopurinol was the most preferred drug for treatment and it was used at an average dose of 171.91 (±53.3) mg/day. The most common side effect was gastrointestinal disturbances (53.13% of patients describing side effects). In regards to the patients' health related quality of life, the physical health presented the lowest mean value 55.9 (±22.34). The risk of kidney failure within five years was low in 41.9%, were moderate in 18.9% and high in 39.2% of patients. Drug interactions were evaluated by the Drugs.com, Lexicomp and Stockley's Interaction Checker and drug interactions were detected in 83 (91.21%) patients. There were differences in clinicians' attitudes towards the management of asymptomatic hyperuricemia. In general, potential drug interactions should be assessed in those patients with high incidence of polypharmacy and progression risk should be reduced and quality of life of patients should be increased by multidisciplinar disease management.