Evaluation of Drug Therapy Problems and Clinical Outcomes in Patients with Chronic Kidney Disease at a Dialysis Centre in Port Harcourt, South South Nigeria

Background: Chronic kidney disease (CKD) complicates drug therapy through altered pharmacokinetics, requiring dose adjustments and avoidance of nephrotoxic agents. Drug therapy problems (DTPs) in CKD patients on haemodialysis are common and clinically consequential. This study evaluated DTPs and associated clinical outcomes in CKD patients at a haemodialysis centre in Port Harcourt, Rivers State. Methods: A prospective observational study enrolled 120 CKD patients on maintenance haemodialysis over four months at a private dialysis centre. Medication profiles were reviewed at each dialysis session by a clinical pharmacist using the Cipolle DTP classification framework. Renal dosing appropriateness was assessed using the Lexicomp Renal Dosing database. Clinical outcomes including hospitalisation rate, blood pressure control, and anaemia management were recorded. Results: A total of 384 DTPs were identified across 120 patients (mean 3.2 per patient). Dosing too high for renal function was the most common DTP (31%), followed by untreated indications (24%) and drug interactions (19%). Pharmacist-recommended interventions were accepted in 68 percent of cases. Patients with pharmacist-resolved DTPs had significantly lower hospitalisations at two months (p = 0.03). Conclusion: DTPs are highly prevalent in haemodialysis patients in Port Harcourt and pharmacist-led medication review substantially improves clinical outcomes. Formal integration of clinical pharmacists into nephrology care teams is recommended. Keywords: drug therapy problems, chronic kidney disease, haemodialysis, Port Harcourt, clinical pharmacy