Prevalence of Polypharmacy and its Financial Burden on Patients Undergoing Hemodialysis

Background: Polypharmacy is highly prevalent among patients with chronic kidney disease (CKD), due to the need for complex pharmacological management. The use of multiple medications increases the risk of financial burden. Data regarding the economic impact of polypharmacy among hemodialysis patients in Libya remain limited. Objective: To determine the prevalence of polypharmacy and evaluate its associated financial burden among patients undergoing maintenance hemodialysis at Zawia Renal Center, Libya. Methods: A cross-sectional study was conducted between August and December 2025 at Zawia Renal Center, Libya. Adult patients (≥18 years) receiving maintenance hemodialysis three times weekly were included. Data were collected using a standardized data collection form. Medication costs were calculated for each participant. Statistical analysis was performed using SPSS version 27. Descriptive statistics summarized the data, while Fisher's Exact test and one-way ANOVA were used to examine associations. A P-value <0.05 was considered statistically significant. Results: A total of 139 patients were included (53.2% male; mean age predominantly ≥50 years). Polypharmacy (5–9 medications) was identified in 85.6% of participants, whereas 7.2% had hyperpolypharmacy (≥10 medications) and 7.2% used fewer than five medications. The overall mean number of medications was 6.55 ± 1.69. Average monthly medication costs increased progressively with medication burden, from approximately 407 Libyan Dinars (LYD) among patients taking 1–4 medications to 735 LYD among those with polypharmacy and 1,141 LYD among patients with hyperpolypharmacy. Most participants belonged to low- or middle-income groups, and only 4.8% had health insurance coverage. Conclusion: Polypharmacy is highly prevalent among Libyan patients undergoing maintenance hemodialysis and is associated with a substantial increase in financial burden. These findings highlight the need for medication optimization strategies and reducing unnecessary polypharmacy among hemodialysis patients.