1 Department of Pharmacy Practice, SGT College of Pharmacy, SGT University, Gurugram, Haryana, India
2 Department of Drug Safety and Pharmacovigilance, Syneos Health, Gurugram, Haryana, India
* Corresponding Author: Ritu Mishra, Department of Pharmacy Practice, SGT College of Pharmacy, SGT University, Gurugram, Haryana, India
Chronic kidney disease patients, especially those with dialysis-dependent conditions, carry a huge medication burden with a daily intake of around 10-12 different medications and a total of almost 19 pills. The state of hyperpolypharmacy results mainly from the necessity to treat a wide range of co-morbidities, such as hypertension, diabetes, and osteoarthritis. Studies have shown that as the number of prescribed medications rises, the patient's health-related quality of life drops considerably. High drug consumption is associated with a decline in physical and mental health, more symptoms, and a higher chance of medication-related problems such as drug interactions and side effects. Besides, there is a "circle of despair" where the increasingly complex medication situation causes non-adherence, hence bad results, and more prescriptions. For example, using over 10 non-essential medications (like some vitamins, or protective drugs for the stomach) correlates very strongly with higher all-cause mortality in patients on haemodialysis. Deprescribing, i.e., the process of effectively identifying and stopping drugs with harmful effects, is greatly emphasized and almost heralded as a way out of this situation. Focus should be on mainstay drugs like antihypertensives, antidiabetics, and statins rather than non-essential supplements. By including clinical pharmacists in the nephrology team, the "prescribing cascades" can be addressed and the treatment regimens can be simplified significantly. Making use of Fixed-Dose Combinations (FDCs) and polypills to lower the pill count physically and increase the level of patient satisfaction is advised. Applying high-level monitoring such as 24-hour ambulatory blood pressure monitoring to ensure minimal prescription. Healthcare providers need not only to be able to prescribe medications but also to be able to deprescribe them if necessary, since only then will patients benefit in terms of their safety, treatment adherence, and overall quality of life.
Keywords: Chronic Kidney Disease, Hyperpolypharmacy, Hypertension, haemodialysis, Fixed-Dose Combinations, Treatment Adherence, Health Related Quality Of Life.
How to cite this article: Dev J, Krishan S, Mishra R. Polypharmacy in Chronic Kidney Disease: Implication for Health-Related Quality of Life and Clinical Outcomes. Int J Drug Deliv Technol. 2026;16(5): 390-397. DOI: 10.25258/ijddt.16.5.40
Source of support: Nil.
Conflict of interest: None