Background: The chronic kidney disease (CKD) is linked to significant morbidity and mortality, especially in those who need maintenance haemodialysis. Evaluation of prescribing patterns and clinical outcomes is crucial since complicated pharmacotherapy is required due to numerous comorbidities and consequences.

Aim: The purpose of this study is to assess the pharmacotherapeutic prescribing patterns, risk factors, and complications of patients with chronic renal disease receiving maintenance haemodialysis.

Methods: 128 patients undergoing maintenance haemodialysis at a tertiary care teaching hospital participated in a cross-sectional observational study. A standardised data collecting form was used to record demographics, comorbidities, clinical and laboratory parameters, complications, and medication use. WHO prescription indicators were used to assess prescribing trends, and statistical analysis was carried out to identify correlations between particular clinical factors.

Results: Males in their middle and older years were more likely to have CKD, and the most common comorbidities were diabetes mellitus and hypertension. The majority of patients had advanced renal failure, anaemia, and complications from haemodialysis. The most commonly given drugs included erythropoietin, loop diuretics, antibiotics, antihypertensives, alkalinising agents, and iron supplements. The WHO prescribing indicators showed an average of 6.7 drugs per prescription, indicating polypharmacy, whereas the high use of generic drugs (81%) and medicines from the National List of Essential Medicines (71%) reflects rational prescribing practices.

Conclusion: Patients on maintenance haemodialysis have a heavy burden of difficulties, comorbidities, and polypharmacy. Improving patient outcomes and quality of life requires early diagnosis, logical pharmacotherapy, clinical pharmacists’ active participation, and a multidisciplinary approach.

KEYWORDS: Chronic Kidney Disease, Hemodialysis, Polypharmacy, Co-morbidities, Risk Factors, Pharmacotherapy, WHO Indicators.