Comparison of dialysis practice and medication prescription pattern in chronic kidney disease patients undergoing hemodialysis at tertiary care and private hospital, Pune, India

Background: Chronic kidney disease (CKD) is a worldwide public health problem associated with various complications. CKD patients undergoing hemodialysis have associated comorbidities and prescribing drugs rationally in these patients is a difficult task. Objective: To evaluate the prescription pattern of chronic kidney disease patients undergoing hemodialysis in both hospitals. Methodology: the study was carried out in a tertiary care and a private hospital for a period of nine months. Chronic kidney disease patients on maintenance hemodialysis for at least one month were included. Details like sociodemographic and clinical characteristics, past medication history, comorbidities, and current medications were noted in self-pre-designed Patient Proforma. Mean +/- standard deviation and percentages and relevant statistical tests likethe Chi-square test was used. Result: The majority of the patients belongedthe to middle socio-economic class in private hospital and the lower-middle classa in tertiary hospital. Maximum were unemployed (50.60%, 36%), married (90.36%, 88,%) and had high school qualification (62.65%, 45.33%). About 78 (93.97%) patients were covered with insurance/health scheme in tertiary hospital and 39 (52%) in private hospital. Hypertension was found to be the leading cause in tertiary and private hospital. Calcium channel blockers (77.10%, 53.30%) were highly prescribed in both hospitals. Erythropoietin (69.80%), calcium acetate (21.70%) an,d anti-diabetics (Insulin 10.84%) in tera tiary hospital, whereas newer and costlier drugs like Darbepoetin, Iron preparations, and Lanthanum carbonate were prescribed ina private hospital. Conclusion: Socioeconomic status led to variation in prescription patterns among both hospitals as newer and costlier drugs like Lanthanum carbonate, Sevelamer, and Darbepoetin were prescribed only in private hospital.