Drug-related problems in hospitalised patients with chronic kidney disease: a systematic review

Research output: Contribution to journalReview articlepeer-review

109 Downloads (Pure)


Introduction: Globally, chronic kidney disease (CKD) is one of the leading causes of mortality. Impaired renal function makes CKD patients vulnerable to drug-related problems (DRPs).

Aim: The aim of this systematic review was to investigate the prevalence and nature of DRPs among hospital in-patients with CKD.

Methods: A systematic review of the literature was conducted using Medline, EMBASE, PsycINFO, Web of Science (Core Collection), CINAHL plus (EBSCO), Cochrane Library (Wiley), Scopus (ELSEVIER) and PubMed (U.S.NLM) from index inception to January 2020. Studies investigating DRPs in hospitalised CKD patients published in the English language were included. Two independent reviewers extracted the data and undertook quality assessment using the Joanna Briggs Institute (JBI) tool.

Results: A total of 2895 unique titles were identified; with 20 meeting the inclusion criteria. DRPs prevalence in CKD was reported between 12 and 87%. The most common DRPs included ineffective treatment, inappropriate drug choice and dosing problems. Antibiotics, H2-antihistamines and oral antidiabetics (metformin) were common drug classes involved in DRPs. Factors associated with DRPs included severity of CKD, the number of medications taken, age, length of hospital stay, and gender.

Conclusion: This systematic review provides evidence that DRPs are a frequent occurrence and burden for hospitalised patients with stage 1–4 CKD. Heterogeneity in study design, case detection and definitions are common, and future studies should use clearer definitions and study designs.

Protocol Registration: PROSPERO: CRD42018096364
Original languageEnglish
Pages (from-to)1041–1058
Number of pages18
JournalDrug Safety
Issue number10
Early online date12 Sept 2021
Publication statusPublished - Oct 2021

Bibliographical note

Funding Information:
The study was funded by the University of Birmingham, and The Saudi Cultural Bureau funded Wadia Alruqayb’s PhD studies. MJP is supported by the NIHR Birmingham Biomedical Research Centre. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.

Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Nature Switzerland AG.

ASJC Scopus subject areas

  • Toxicology
  • Pharmacology
  • Pharmacology (medical)


Dive into the research topics of 'Drug-related problems in hospitalised patients with chronic kidney disease: a systematic review'. Together they form a unique fingerprint.

Cite this