Researchers studied 96 patients receiving kidney dialysis treatment to understand how many medications they take and how it affects their health. They found that about 6 out of 10 patients took four or more medications daily. Patients taking more medications had more health problems and were at higher risk for malnutrition. The study suggests that doctors need to carefully review all the medications kidney patients take to make sure they’re really necessary and to help prevent serious nutritional problems that can develop during dialysis treatment.

The Quick Take

  • What they studied: How many medications kidney dialysis patients take and whether taking lots of medications is connected to malnutrition and other health problems
  • Who participated: 96 patients who were receiving regular kidney dialysis treatment at a hospital over a two-year period
  • Key finding: About 60% of dialysis patients took 4 or more medications daily, and these patients had more health complications and were more likely to be malnourished compared to patients taking fewer medications
  • What it means for you: If you or a loved one receives kidney dialysis, doctors should regularly review all medications to make sure each one is truly needed. This may help prevent serious nutritional problems that can develop during dialysis treatment. However, this is one study and more research is needed before making major changes to medication routines.

The Research Details

This was a cross-sectional study, which means researchers looked at a group of patients at one point in time and collected information about their medications, health conditions, and nutrition status. They reviewed medical records from 96 kidney dialysis patients over a two-year period and gathered information about what medications each patient was taking, how many health problems they had, and signs of malnutrition. The researchers defined “polypharmacy” (taking many medications) as using 4 or more drugs per day. They used a scoring system called the Malnutrition-Inflammation Score to identify patients at risk for protein-energy wasting, which is a serious nutritional problem common in dialysis patients.

This research approach is important because it shows real-world patterns in how many medications dialysis patients actually take and connects this to their health outcomes. By looking at actual patient data rather than doing an experiment, researchers can understand what’s really happening in clinical practice. This information helps doctors understand whether medication management might be contributing to nutritional problems in their patients.

This study has some strengths: it looked at real patient data from a two-year period and measured multiple health factors. However, there are limitations to consider: it only included 96 patients from one location, so results may not apply to all dialysis patients everywhere. The study design (cross-sectional) shows relationships between medications and health problems but cannot prove that medications directly cause nutritional problems. The researchers did not have information about why patients were taking each medication, which would help explain the findings better.

What the Results Show

The study found that 60.4% of the 96 dialysis patients (58 patients) were taking 4 or more medications daily. The most commonly used medications were iron supplements given through the vein (90.6% of patients), medications to stimulate red blood cell production (65.6%), blood pressure medications (58%), and vitamin D (43.7%). Patients taking more medications had higher body weight relative to their height and higher iron storage levels in their blood. However, they also had lower levels of a protective type of cholesterol (HDL) and lower creatinine levels, which may indicate they were losing more muscle. About one-third of all patients (34.8%) showed signs of serious malnutrition, and this malnutrition was more common in patients taking many medications (21.7% of the polypharmacy group). Patients taking more medications also had more overall health problems according to a scoring system that measures comorbidity.

The study found that patients with polypharmacy had higher comorbidity scores, meaning they had more chronic health conditions overall. The connection between taking many medications and malnutrition risk was notable, suggesting that either the medications themselves, the conditions requiring the medications, or both together may contribute to nutritional problems. The specific types of medications used (iron, blood pressure drugs, and red blood cell stimulators) are standard treatments for dialysis patients, but the study suggests their combined effect on nutrition deserves attention.

Previous research has shown that dialysis patients commonly take multiple medications because they have kidney disease plus other health conditions like high blood pressure and anemia. This study confirms that polypharmacy is very common in dialysis patients (60% in this study) and adds new information by showing a clear connection to malnutrition risk. The finding that malnutrition is more common in patients taking more medications aligns with other research suggesting that medication management is an important part of preventing nutritional problems in dialysis patients.

This study only included 96 patients from what appears to be one hospital, so the results may not apply to all dialysis patients in different locations or countries. The study design cannot prove that medications cause malnutrition—it only shows they occur together. The researchers did not have detailed information about why each patient was taking each medication or whether doses were appropriate. The study did not follow patients over time to see if changes in medications led to changes in nutrition status. Additionally, the study did not account for other factors that might affect nutrition, such as diet quality or appetite changes.

The Bottom Line

Based on this research, dialysis patients and their doctors should: (1) Regularly review all medications to make sure each one is truly necessary—this is called medication reconciliation; (2) Monitor nutrition status closely, especially in patients taking many medications; (3) Consider working with a dietitian who specializes in kidney disease to ensure adequate nutrition despite medication use. These recommendations have moderate confidence because they’re based on one observational study. More research is needed to determine the best ways to manage medications while protecting nutrition in dialysis patients.

This research is most relevant to: patients receiving kidney dialysis treatment, their family members, nephrologists (kidney doctors), dialysis nurses, and dietitians working with dialysis patients. People with early-stage kidney disease should also be aware that managing medications carefully may help prevent some complications. This research does not directly apply to people with normal kidney function or those not receiving dialysis.

Changes in nutrition status from medication adjustments typically take weeks to months to become noticeable. If a doctor decides to reduce or change medications, improvements in nutrition markers (like albumin levels) might appear in 4-8 weeks. However, some nutritional improvements may take longer. Patients should not stop taking medications without talking to their doctor, as each medication serves an important purpose.

Want to Apply This Research?

  • Track daily medication count and nutrition markers: Record the number of medications taken each day and note any changes in appetite, weight, or energy levels. If possible, track lab values like albumin and prealbumin (nutrition markers) at each dialysis clinic visit to see if nutrition status is improving or declining.
  • Work with your dialysis team to create a simple medication list organized by time of day. Use the app to set reminders for each medication and note any side effects or concerns. Share this list with all your doctors to help them understand your complete medication picture and identify any medications that might be unnecessary.
  • Monthly: Review your medication list with your doctor or pharmacist to discuss whether each medication is still needed. Track your weight and appetite weekly. Every 3 months: Check your nutrition lab values (albumin, prealbumin) at your dialysis clinic and discuss results with your dietitian. Use the app to create a trend chart showing how your nutrition markers change over time relative to any medication changes.

This research describes patterns in medication use among dialysis patients and suggests a connection to malnutrition risk. It does not prove that medications cause malnutrition. Dialysis patients should never stop or change medications without consulting their nephrologist or dialysis team, as each medication serves an important purpose in managing kidney disease and related conditions. This information is for educational purposes and should not replace professional medical advice. If you receive dialysis treatment, discuss these findings with your healthcare team to determine what’s appropriate for your individual situation. Medication decisions should always be made by qualified healthcare providers who understand your complete medical history.