International Journal of Clinical Pharmacy

, Volume 40, Issue 5, pp 1217–1224 | Cite as

Medication-related problems among adult chronic kidney disease patients in a sub-Saharan tertiary hospital

  • Lisper Wangeci NjeriEmail author
  • William Otieno Ogallo
  • David Gitonga Nyamu
  • Sylvia Adisa Opanga
  • Alfred Rugendo Birichi
Research Article



Chronic kidney disease (CKD) patients are prone to medication-related problems (MRPs). Few studies address the clinical relevance of MRPs among CKD patients in sub-Saharan Africa.


To investigate the frequency and predictors of MRPs among adult CKD patients treated at a tertiary care facility in an urban sub-Saharan setting.


Kenyatta National Hospital in Nairobi, Kenya.


A cross-sectional study involving 60 adult patients with CKD was carried out. Data were collected through structured interviews and patient chart reviews between April 2016 and June 2016. MRPs identified from the collected data were classified according to Hepler and Strand classification. The frequencies of the identified MRPs were computed and logistic regression used to investigate the associations between the MRPs and covariates in the data. Main outcome measures: frequencies and predictors of MRPs.


271 MRPs were identified. The commonest MRPs were drug interactions (21.8%), indication without drug (18.1%) and medication non-adherence (15.5%). Compared to patients with CKD stage 3, patients with CKD stage 4 were 5.9 times more likely to have an improper drug selection and 4.7 times more likely to experience overdosage. Other significant predictors of MRPs were the number of medications per prescription and the number of comorbidities per patient.


This study found a high frequency of MRPs among patients with chronic kidney disease receiving care in urban sub-Saharan tertiary hospital settings. The predictors of MRPs among CKD patients in this setting are likely to be multifactorial and include the CKD stage, polypharmacy, and comorbidities.


Chronic kidney disease Medication-related problems Sub-Saharan Africa Tertiary hospital DRP Kenya 



We would like to acknowledge our participants at the Kenyatta National Hospital renal clinic and medical wards. Special thanks to respective matrons.


The study was partially funded by the Kenyatta National Hospital Research and Programs Department and the University of Nairobi. The funding organizations had no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.

Conflicts of interest

The authors (all of them) declare that they have no conflict of interest.

Supplementary material

11096_2018_651_MOESM1_ESM.pdf (269 kb)
Supplementary material 1 (PDF 268 kb)


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Pharmaceutics and Pharmacy Practice, School of PharmacyUniversity of NairobiNairobiKenya
  2. 2.Biomedical InformaticsColumbia UniversityNew YorkUSA
  3. 3.Department of Pharmaceutics and Pharmacy Practice, School of PharmacyUniversity of NairobiNairobiKenya
  4. 4.Department of PharmacyKenyatta National HospitalNairobiKenya

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