# Medication Use and Adverse Events in CKD

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2020 · $719,054

## Abstract

PROJECT SUMMARY/ABSTRACT
 Our long-term objective is to promote appropriate, safe, and effective use of medications across the range
of kidney function. Adverse drug events represent a significant source of morbidity and mortality worldwide,
and people with chronic kidney disease (CKD) – a condition afflicting >10% of adults globally – are at
particularly high risk. People with CKD often take 10 or more medications, some of which require dose
adjustment in impaired kidney function. However, recommendations for medication use, dosing, and
monitoring are based on limited evidence and are inconsistent.
 We propose to use data from 5 million participants in 5 international cohorts to identify and validate
medication-adverse event associations in order to inform safer health care in the ambulatory setting. First, we
will assess the most frequently used medications according to glomerular filtration rate (GFR) and albuminuria,
as well as patterns of use associated with CKD stage. We will then focus early work on commonly-used
medications for which there is insufficient evidence to guide risk-benefit assessment in CKD. Second, we will
define and abstract outcomes of interest, including possible sequelae of medication use, such as acute kidney
injury, gastrointestinal bleeding, and electrolyte abnormalities, and test their associations with CKD stage.
Third, we will link medication use to adverse outcomes across the spectrum of kidney function, comparing
medication users to non-users through sophisticated pharmacoepidemiology techniques. We will specifically
evaluate for thresholds of kidney function in which risks of adverse drug event increase, as well as concomitant
patient characteristics or use of medications that alter risks. Each aim will be performed individually in one of
the cohorts, replicated in the others, and then meta-analyzed.
 The investigative team has extensive experience in big data, pharmacoepidemiology techniques, and
meta-analyses, including direct experience with each of the proposed cohorts. The project will inform objective
assessment of the risks associated with many medications across the spectrum of kidney function, including
both GFR and albuminuria. Results will allow for the advancement of prevention efforts, including the design of
evidence-based tools for individualized clinical decision-making in ambulatory medicine, leading to the safer
use of medications in all patients.

## Key facts

- **NIH application ID:** 9989831
- **Project number:** 5R01DK115534-03
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Morgan Erika Grams
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $719,054
- **Award type:** 5
- **Project period:** 2018-08-01 → 2022-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9989831

## Citation

> US National Institutes of Health, RePORTER application 9989831, Medication Use and Adverse Events in CKD (5R01DK115534-03). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/9989831. Licensed CC0.

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