PACIENTES RENAIS CRÔNICOS ATENDIDOS NA FARMÁCIA ESTADUAL DE MEDICAMENTOS ESPECIALIZADOS NO MUNÍCIPIO DE SÃO LUÍS, MARANHÃO: Perfil clínico-epidemiológico, estudo etnofarmacológico e estratégias para Farmacovigilância

Abstract

Chronic Kidney Disease (CKD) is a syndrome characterized by progressive changes in renal structure and function, presenting high morbidity and mortality and a significant socioeconomic impact. Due to its complex clinical progression, the disease requires continuous care and prolonged use of medications to ensure access to therapies that control the progression of the pathology and reduce complications, making the Specialized Component of Pharmaceutical Assistance essential in Brazil. However, the traditional use of medicinal plants and barriers to accessing health services encourage self-medication with herbal preparations, which can represent serious risks to patients with CKD due to possible adverse events. Given this scenario, this study aimed to describe the epidemiological profile and pattern of use of plants for medicinal purposes among patients with CKD, evaluating potential risks of drug interactions with specialized treatment and proposing measures to minimize dangers in this population. The methodology consisted of an observational, cross-sectional, and analytical study with 280 patients registered in the Horus system and assisted by the State Pharmacy of Specialized Medicines in São Luís, Maranhão, Brazil. Data were collected through interviews using a structured questionnaire, and medical records were used to confirm the disease; multivariate logistic regression analysis was applied to identify factors associated with the use of plants for medicinal purposes. The results revealed a sample with a slight male predominance (50.71%) and a higher concentration in the 51-60 age group (22.86%). The socioeconomic profile showed low educational attainment, with 70.00% of patients having completed high school, and marked financial vulnerability, with 93.57% living on less than two minimum wages. Regarding the diagnosis of CKD, 51.79% discovered the disease in routine examinations, although 18.21% had a family history, mainly first-degree relatives (34%). The practice of polypharmacy is evident, with 78.57% of respondents using additional medications, primarily for the control of metabolic disorders and hypertension. Approximately 15% of patients use plants for medicinal purposes, with the most frequent species being: lemon balm (Lippia alba (Mill.) N.E. Br., 5.36%), lemongrass (Cymbopogon citratus (DC.) Stapf, 3.57%), chamomile (Matricaria recutita L., 2.14%), boldo (Plectranthus barbatus Andrews, 1.79%), and mango leaf (Mangifera indica L, 1.07%). Thus, the clinical risk is aggravated by polypharmacy and/or the use of species with nephrotoxic potential. It is concluded that the implementation of pharmacovigilance actions and the qualification of healthcare professionals are imperative measures to mitigate risks and promote the rational use of therapeutic resources in this population.