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Chronic Kidney Disease

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Overview

Chronic kidney disease (CKD), an irreversible, progressive decline in kidney function, is a major cause of illness and death. A large, population-based survey found that, during the time period 1999-2004, 13% of U.S. adults had CKD (increased from 10% during 1988-1994) – and that survey did not count hospitalized patients and long-term care residents. CKD prevalence increases with age, from less than 5% of people age 20-39 years, to more than 45% of those age 70 and older.

This issue serves as a primer for CKD. It provides a general overview of the causes and complications of CKD, including a discussion of glomerular filtration rate, creatinine clearance, and the role of each in CKD management. Current treatment recommendations, based on The Kidney Disease Outcomes Quality Initiative (KDOQI) from the National Kidney Foundation, are summarized. A discussion of the most important considerations for drug dosing in patients with impaired kidney function is also included. This discussion is paired with practical tables listing frequently prescribed drugs that are nephrotoxic, may impair kidney function, or are commonly used in CKD and require dose adjustment.

Publication Date: Oct-1-11
Expiration Date: Oct-1-14
CE Credit: 1.5 (0.15 CEU)
Type of activity: Knowledge-based

This program was developed by The Rx Consultant and published by Continuing Education Network, Inc. The Rx Consultant accepts no advertising or financial support from the pharmaceutical industry and is funded solely by the purchase of programs. The Rx Consultant is dedicated to providing unbiased, balanced information to health care practitioners.

Programs developed by The Rx Consultant are written by health care providers with expertise in the topic area, peer-reviewed, extensively edited, and fact-checked. This development process was created to insure that every program presents information that is current, accurate, relevant to "real world" health care providers, and written in an easy reading, "plain English" style.

Authors

Pamela Mausner, MD

Disclosure Statement

Dr. Mausner reports no financial or personal relationship with any commercial interest producing, marketing, ?reselling, or distributing a product or service that appears in this issue.

Target Audience

This accredited program is targeted to pharmacists and nurses.

Goals & Objectives

At the conclusion of this program, participants will be able to:

  • Define chronic kidney disease (CKD) and name the 2 most common causes. Counsel patients about lifestyle changes to slow CKD progression.
  • Describe the role of ACE inhibitors, ARBs, diuretics, and calcium channel blockers in CKD management. Weigh the pros and cons of different drug classes for diabetes and dyslipidemia management in CKD patients.
  • Discuss drug therapy for the common complications of CKD.
  • Adjust drug dosages in patients with CKD, based on creatinine clearance (CrCl) or glomerular filtration rate (GFR).

Exam & Credit Statement procedures

Upon successful completion of this program and the post test (70%), 1.5 hours of continuing education credit will be awarded. To receive credit and your exam score, please complete the exam questions and program evaluation.

Editorial and Review Board

Editor and CE Administrator

Terry M. Baker, PharmD

Associate Editor and CE Coordinator

Tracy Farnen, PharmD

Associate Editors

James Chan, PharmD, PhD
Pharmacy Quality and Outcomes Coordinator
Kaiser Permanente
Oakland, CA

Associate Clinical Professor
School of Pharmacy
University of California San Francisco
San Francisco, CA

Ron Finley, RPh
Lecturer
Department of Clinical Pharmacy
University of California San Francisco
San Francisco, CA

Associate Member of the UCSF Memory and Aging Center
Alzheimer's Research Center

Consultant Pharmacist to the Institute on Aging-On Lok Senior Health
Institute on Aging Alzheimer's Day Care Center

Angie S. Graham, PharmD
Drug Information Coordinator
Stanford Hospital and Clinics
Stanford University Medical Center
Stanford, CA

Julio R. Lopez, PharmD, FCSHP
Chief of Pharmacy Service
VA Northern California Health Care System

Adjunct Clinical Professor
College of Pharmacy
Touro University
Vallejo, CA

Assistant Clinical Professor
School of Pharmacy
University of California, San Francisco
San Francisco, CA

Adjunct Professor
Thomas J. Long School of Pharmacy
University of the Pacific
Stockton, CA

Visiting Associate Professor and Lecturer
Nursing School
Samuel Merritt University
Oakland, CA

Pamela Mausner, MD

Joshua J. Neumiller, PharmD, CDE, CGP, FASCP
Assistant Professor
Department of Pharmacotherapy
College of Pharmacy
Washington State University
And
Elder Services of Spokane
Spokane, WA

Candy Tsourounis, PharmD
Professor of Clinical Pharmacy
Medication Outcomes Center
Department of Clinical Pharmacy
School of Pharmacy
University of California, San Francisco
San Francisco, CA

Senior Editorial Advisor

Gerard Hatheway, PharmD, PhD

Editorial Advisors

Jocelyn Chan, PharmD
Belinda M. Danielson, RPh
Christopher M. DeSoto, PharmD
Cynthia Chan Huang, PharmD, MBA
Fred Plageman, PharmD


Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners

Emily K. Meuleman, RN, C, MS

Accreditation Statements

The Rx Consultant is a publication of Continuing Education Network, Inc.

Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.
Continuing Education Network is approved by the California Board of Registered Nursing, Provider Number CEP 13118. Programs approved by CA BRN are accepted by most State Boards of Nursing.

About the Rx Consultant

The Rx Consultant is a monthly publication dedicated to providing health care professionals with the information they need to educate patients about drugs and manage drug therapy. The reader is responsible for confirming the information presented here and interpreting it in relation to each patient's specific situation before utilizing the information.

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