AuthorCedillo-Couvert, Esteban A.
Ricardo, Ana C.
Fischer, Michael J.
Kusek, John W.
Porter, Anna C.
Sharp, Lisa K.
Lash, James P.
Appel, Lawrence J.
Feldman, Harold I.
Go, Alan S.
Kusek, John W.
Lash, James P.
Rao, Panduranga S.
Townsend, Raymond R.
AffiliationUniv Arizona, Dept Med
MetadataShow full item record
PublisherELSEVIER SCIENCE INC
CitationCedillo-Couvert, E. A., Ricardo, A. C., Chen, J., Cohan, J., Fischer, M. J., Krousel-Wood, M., ... & Porter, A. C. (2018). Self-reported Medication Adherence and CKD Progression. Kidney international reports, 3(3), 645-651. https://doi.org/10.1016/j.ekir.2018.01.007
JournalKIDNEY INTERNATIONAL REPORTS
Rights© 2018 International Society of Nephrology. Published by Elsevier Inc.
Collection InformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at firstname.lastname@example.org.
AbstractIntroduction: In the general population, medication nonadherence contributes to poorer outcomes. However, little is known about medication adherence among adults with chronic kidney disease (CKD). We evaluated the association of self-reported medication adherence with CKD progression and all-cause death in patients with CKD. Methods: In this prospective observational study of 3305 adults with mild-to-moderate CKD enrolled in the Chronic Renal Insufficiency Cohort (CRIC) Study, the baseline self-reported medication adherence was assessed by responses to 3 questions and categorized as high, medium, and low. CKD progression (50% decline in eGFR or incident end-stage renal disease) and all-cause death were measured using multivariable Cox proportional hazards. Results: Of the patients, 68% were categorized as high adherence, 17% medium adherence, and 15% low adherence. Over a median follow-up of 6 years, there were 969 CKD progression events and 675 deaths. Compared with the high-adherence group, the low-adherence group experienced increased risk for CKD progression (hazard ratio = 1.27, 95% confidence interval = 1.05, 1.54) after adjustment for sociodemographic and clinical factors, cardiovascular medications, number of medication types, and depressive symptoms. A similar association existed between low adherence and all-cause death, but did not reach standard statistical significance (hazard ratio - 1.14 95% confidence interval - 0.88, 1.47). Conclusion: Baseline self-reported low medication adherence was associated with an increased risk for CKD progression. Future work is needed to better understand the mechanisms underlying this association and to develop interventions to improve adherence.
NoteOpen access journal.
VersionFinal published version
SponsorsU.S. National Institute of Diabetes and Digestive and Kidney Diseases [U01DK060990, U01DK060984, U01DK061022, U01DK061021, U01DK061028, U01DK060980, U01DK060963, U01DK060902]; Perelman School of Medicine at the University of Pennsylvania Clinical and Translational Science Award [NIH/NCATS UL1TR000003]; Johns Hopkins University [UL1 TR-000424]; University of Maryland [GCRC M01 RR-16500]; Clinical and Translational Science Collaborative of Cleveland from the National Center for Advancing Translational Sciences (NCATS) component of the National Institutes of Health [UL1TR000439]; Michigan Institute for Clinical and Health Research (MICHR) [UL1TR000433]; University of Illinois at Chicago [CTSA UL1RR029879]; Tulane University Translational Research in Hypertension and Renal Biology [P30GM103337]; Kaiser Permanente Northern California [NIH/NCRR UCSF-CTSI UL1 RR-024131]; NIDDK [K24DK092290, K23DK094829]; Research Supplement to Promote Diversity in Health-Related Research [U01-DK060980]; NIH roadmap for Medical Research
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