In addition to experiencing negative health effects from their disease, patients with chronic kidney disease (CKD) are also at risk of experiencing hazardous events potentially related to medical treatments they receive. A study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN) finds that low blood sugar and high blood potassium being common complications of their medical care.
Patients with CKD are susceptible to experiencing harm related to the care they receive due to their impaired kidney function and the complexity of the medical treatments they undergo.
Some studies have assessed the harms that CKD patients experience when they're hospitalized, but most of the care they receive is delivered outside of the hospital. Jennifer Ginsberg, Jeffrey Fink, MD (University of Maryland School of Medicine), and their colleagues examined 267 CKD patients enrolled in the ongoing Safe Kidney Care study, which attempts to determine the frequency of complications of medical care pertinent to the outpatient treatment of patients with CKD. The researchers looked for patient-reported adverse safety incidents (class I), which are reported hazardous events or symptoms that study participants attribute to a medication, as well as actionable safety findings (class II), which are hazardous clinical disturbances detected at study evaluations that have the potential to be corrected with treatment or medication modification.
Among the major findings:
• A total of 185 patients (69.3%) had at least one class I or II event, 102 (38.2%) had more than one event, and 48 (18.0%) had at least one event from both classes.
• The most common class I event was low blood sugar (hypoglycemia).
• The most common class II event was high blood potassium (hyperkalemia).
• Hypoglycemia (in patients with diabetes) and falling or severe dizziness (in patients without diabetes) were most frequently paired with other complications of medical care.
"Disease-specific adverse safety event events are strikingly common in CKD and in the setting of medications that can account for such events. It is possible that efforts to prevent these unintended events will reduce the rate of renal function loss and poor outcomes in patients with CKD," said Dr. Fink.
- J. S. Ginsberg, M. Zhan, C. J. Diamantidis, C. Woods, J. Chen, J. C. Fink. Patient-Reported and Actionable Safety Events in CKD. Journal of the American Society of Nephrology, 2014; DOI: 10.1681/ASN.2013090921
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