Around 26 million Americans have chronic kidney disease (CKD), according to the National Kidney Foundation. And some 200,000 of them have such limited or failed kidney function they have to go through dialysis, a several-times-a-week procedure that filters waste from the blood. CKD patients on dialysis also are subjected to more prescription medications than most other people with chronic diseases. In fact, they often are given a mind-boggling number of pills to take daily. And while these drugs are prescribed to help control kidney disease, a new study in the Clinical Journal of the American Society Nephrology (CJASN) concludes the more pills dialysis patients take each day, the worse their health-related quality of life becomes , including the ability to simply enjoy daily activities.

Rajnish Mehrotra, MD and Yi-Wen Chiu, MD, of the Los Angeles Biomedical Research Institute, headed a team of researchers who studied 233 chronic dialysis patients from three clinics in different geographic areas in the U.S. They wanted to see how the enormous "pill burden" of these research subjects affected their lives. They found that, on average, kidney disease patients took 19 pills daily -- with a quarter of them downing more than 25 pills a day.

So did patients on more medications have better perceived health? The scientists found just the opposite was true: the more pills the CKD patients popped to help their disease, the worse most of them felt, both physically and mentally.

One particular class of drugs called phosphate binders accounted for about half of the daily pills taken by the kidney disease patients. Phosphate binders reduce toxic levels of phosphorous in the blood that build up when kidneys can't do their job. However, the study found that 62 percent of the patients didn't take these drugs like they were told to. In fact, the more phosphate binders that were prescribed for patients, the less likely the CKD sufferers were to take their drugs as directed. That meant they were less to have their blood phosphorous levels under control.

In a statement to the media, the researchers said their findings indicate that increasing the number of prescribed pills not only doesn't improve control of phosphorous levels but may also result in a poorer health-related quality of life for CKD patients, including experiencing unpleasant side effects. Phosphate binders, specifically, are known to cause a host of unpleasant reactions including constipation, diarrhea, a general feeling of being sick, potential memory problems and a chalky taste in the mouth. The authors of the study also emphasized that any attempts to reduce the pill burden of dialysis patients must take into consideration the large number of phosphate binder pills kidney diseae patients are often told they must take on a daily basis.

Meanwhile, other researchers are looking for safer ways to reduce blood levels of phosphorous in CKD. Last year, scientists from the Nephrological Department at Rigshospitalet in Copenhagen, Denmark, published a study in the Danish Medical Bulletin suggesting that a form of vitamin D could be beneficial for kidney disease patients who need phosphorous levels lowered.

For more information:

http://jasn.asnjournals.org

http://www.kidney.org/kidneydisease/

http://www.kidney.org/atoz/atozItem.cfm?id=39

http://health.nih.gov/topic/KidneyFailureandDialysis

http://www.ncbi.nlm.nih.gov/pubmed/1923 ... d_RVDocSum