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Nephrology

Welcome to the nephrology category for physicians and pharmacists. This clinical category features links to resources on renal guidelines, calculating GFR and eGFR, prescribing in CKD (chronic kidney disease) and renal impairment including drug dose adjustments and more.

The Renal Association Clinical Practice Guidelines

Source: renal.org
Clinical Resource: Guidelines
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Last Checked: 30/12/13 Link Error: Report It

 

Kidney Disease Outcomes Quality Initiative Guidelines

Source: kidney.org
Clinical Resource: Guidelines
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Last Checked: 21/08/15 Link Error: Report It

 

Caring for Australasians with Renal Impairment (CARI) Chronic Kidney Disease Guidelines

Source: cari.org.au
Clinical Resource: Guidelines
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Last Checked: 24/02/14 Link Error: Report It

 

Caring for Australasians with Renal Impairment (CARI) Dialysis Guidelines

Source: cari.org.au
Clinical Resource: Guidelines
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Last Checked: 24/02/14 Link Error: Report It

 

Caring for Australasians with Renal Impairment (CARI) Transplantation Guidelines

Source: cari.org.au
Clinical Resource: Guidelines
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Last Checked: 24/02/14 Link Error: Report It

 

Canadian Society of Nephrology Clinical Practice Guidelines

Source: csnscn.ca
Clinical Resource: Guidelines
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Last Checked: 16/03/13 Link Error: Report It

 

European Renal Best Practice (ERBP) Guidelines

Source: european-renal-best-practice.org
Clinical Resource: Guidelines
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Last Checked: 16/03/13 Link Error: Report It

 

European Best Practice Guidelines (EBPG) Guidelines

Source: european-renal-best-practice.org
Clinical Resource: Guidelines
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Last Checked: 16/03/13 Link Error: Report It

 

 

Scottish Intercollegiate Guidelines Network (SIGN) Guideline > Diagnosis and Management of Chronic Kidney Disease

Source: sign.ac.uk
Clinical Resource: Guideline
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Last Checked: 18/05/15 Link Error: Report It

 

 

Edren textbook

The Edren textbook is aimed at those with some medical knowledge who need to know the essentials on renal topics. Some medical knowledge is assumed but each section is intended to provide a short introduction to the topic.

Source: edrep.org
Clinical Resource: Textbook
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Last Checked: 16/03/13 Link Error: Report It

 

Chronic Kidney Disease (CKD) Algorithm

Source: elmmb.nhs.uk
Clinical Resource: Algorithm
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Last Checked: 17/07/13 Link Error: Report It

 

Chronic Kidney Disease - A Guide for Primary Care

The resource includes detailed information in the following areas:

  • CKD – Why it has become an important issue – Epidemiology, NEOERICA, NHANES, increase in RRT population and the cost of RRT
  • Causes of CKD – Diabetes, hypertension, obstruction and infection
  • Medicines Management – pharmacology and modes of action
  • Management of Hypertension – approach to lowering BP, Proteinuria, antihypertensive strategy, ACE inhibitors and ARBs
  • Nutrition – healthy eating, malnutrition and weight management in CKD
  • What to tell patients – Self management, self monitoring and referral
  • Primary care – QOF, when to refer, management plans in primary care
Source: ckdonline.org
Clinical Resource: CE / CPD / Learning
Register to Access Content: Yes - registration is FREE

Last Checked: 16/03/13 Link Error: Report It

 

Chronic Kidney Disease (CKD) Management in General Practice

This 3rd edition is the synthesis of the evolving evidence that the management of kidney disease matters.

The Kidney Check Australia Task Force (KCAT) - now in its 13th year - has produced this handbook in the hope that practitioners will find the recommendations helpful in individuals at risk or with kidney disease and above all be inspired to identify kidney disease in their patients.

The 3rd edition of this handbook has been officially recognised as an Accepted Clinical Resource by the Royal Australian College of General Practitioners and has been endorsed by the Australian Primary Health Care Nurses Association and the Australian and New Zealand Society of Nephrology.

Source: kidney.org.au
Clinical Resource: Book
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Last Checked: 19/10/15 Link Error: Report It

 

National Kidney Foundation
CME/CE Activities

The National Kidney Foundation (NKF) is accredited by the Accreditation Council for Continuing Medical Education (ACCME), an approved provider through the Ohio Nurses Association (ONA), Commission on Dietetic Registration (CDR) and Association for Social Work Boards (ASWB) to provide continuing education to physicians, nurses/dialysis technicians, dietitians and social workers respectively. In addition, individual activities are approved on an activity specific basis for family physicians, advanced practitioners (nurse practitioners and physician assistants), pharmacists, certified case managers, certified rehabilitation counselors, and other specialties.

Source: kidney.org
Clinical Resource: CE / CPD / CME / Learning
Register to Access Content: Yes - registration is FREE

Last Checked: 21/08/15 Link Error: Report It

 

American Society of Nephrology Geriatric Nephrology Curriculum

The 38 chapters in this online text address the most significant aspects of caring for aging patients with kidney disease, including assessing GFR in the elderly, drug dosing and renal toxicity, management of ESRD in elderly patients, and end of life decision making.

Source: asn-online.org
Clinical Resource: Curriculum
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Last Checked: 07/04/14 Link Error: Report It

 

Biomarkers in Nephrology: Core Curriculum 2013

In this Core Curriculum, we aim to discuss both conventional and novel biomarkers of kidney disease in the settings of acute kidney injury (AKI), chronic kidney disease (CKD), nephrotoxin exposure, and glomerulonephritis.

Source: ajkd.org
Clinical Resource: Journal Article
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Last Checked: 05/05/15 Link Error: Report It

 

Abnormal Renal Function and Electrolyte Disturbances in Older People

Older people are also susceptible to electrolyte disturbances, especially if they have concomitant diseases, such as heart failure, and are receiving diuretics and blockers of the reninangiotensin system. Management of these patients requires skill, as well as realistic objectives. In this article we discuss some of the issues pertaining to renal and electrolyte abnormalities experienced by older people.

Source: shpa.org.au
Clinical Resource: Journal Article
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Last Checked: 16/03/13 Link Error: Report It

 

Chronic kidney disease frequently asked questions

NHS Employers and the General Practitioners Committee (GPC) of the British Medical Association (BMA) have published these frequently asked questions (FAQs) in response to queries received from primary care organisations and practices, in relation to the diagnosis and management of chronic kidney disease following its inclusion in the Quality and Outcomes Framework (QOF) in 2006.

Source: britishrenal.org
Clinical Resource: Frequently Asked Questions
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Last Checked: 16/03/13 Link Error: Report It

 

American Society of Diagnostic and Interventional Nephrology Position Papers

Source: asdin.org
Clinical Resource: Position Papers
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Last Checked: 16/03/13 Link Error: Report It

 

National Institute for Health and Care Excellence (NICE) Guidance > Peritoneal dialysis: Peritoneal dialysis in the treatment of stage 5 chronic kidney disease

Source: nice.org.uk
Clinical Resource: Guidance
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Last Checked: 18/05/15 Link Error: Report It

 

BestBETs
Renal

BETs were developed in the Emergency Department of Manchester Royal Infirmary, UK, to provide rapid evidence-based answers to real-life clinical questions, using a systematic approach to reviewing the literature. BETs take into account the shortcomings of much current evidence, allowing physicians to make the best of what there is.

Source: bestbets.org
Clinical Resource: Evidence Based Answers to Clinical Questions
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Last Checked: 16/03/13 Link Error: Report It

 

The Cochrane Collaboration
Cochrane Reviews - Kidney Disease

The Cochrane Collaboration is an international, non-profit, independent organisation, established to ensure that up-to-date, accurate information about the effects of healthcare interventions is readily available worldwide. It produces and disseminates systematic reviews of healthcare interventions, and promotes the search for evidence in the form of clinical trials and other studies of the effects of interventions.

Source: cochrane.org
Clinical Resource: Systematic Reviews
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Last Checked: 13/07/15 Link Error: Report It

 

Management of acute renal failure

Acute renal failure is a common condition, frequently encountered in both community practice and hospital inpatients. While it remains a heterologous condition, following basic principles makes investigation straightforward, and initial management follows a standard pathway in most patients. This article shows this, advises on therapeutic strategies, including those in special situations, and should help the clinician in deciding when to refer to a nephrologist, and when to consider renal replacement therapy.

Source: nih.gov
Clinical Resource: Journal Article
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Last Checked: 16/03/13 Link Error: Report It

 

Kidney Disease Improving Global Outcomes Clinical Practice Guideline for Acute Kidney Injury

Source: kdigo.org
Clinical Resource: Guideline
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Last Checked: 21/08/15 Link Error: Report It

 

 

Diagnosis and Management of Chronic Kidney Disease

On completion of this article you should be able to (1) identify the 3 forms of renal damage that can cause an elevated serum creatinine level, (2) develop a plan for the initial evaluation of the patient with an elevated serum creatinine level, and (3) identify the measures that should be taken to help preserve renal function in patients with an elevated serum creatinine level.

Source: mayoclinicproceedings.org
Clinical Resource: Journal Article
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Last Checked: 16/03/13 Link Error: Report It

 

Aintree University Hospitals NHS
Guidelines for the Management of Hyperkalaemia in Patients with Kidney Failure

Hyperkalaemia is a life-threatening condition that can be particularly difficult to manage in patients who have co-existing kidney failure.

Source: aintreerenalunit.nhs.uk
Clinical Resource: Guideline
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Last Checked: 16/03/13 Link Error: Report It

 

Drug-Induced Acute Renal Failure

Acute renal failure (ARF) is defined as a rapid loss of renal function due to damage to the kidneys. This results in electrolyte and acid-base abnormalities and retention of nitrogenous waste products, such as urea and creatinine.

Source: uspharmacist.com
Clinical Resource: Journal Article
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Last Checked: 16/03/13 Link Error: Report It

 

Toxic Nephropathies: Core Curriculum 2010

Toxic nephropathies are an important and relatively common category of kidney damage. Although they generally are reversible when detected early, they may be permanent, leading to chronic kidney disease (CKD). Toxic nephropathies are defined primarily as kidney injury caused by any number of medications, diagnostic agents, alternative products, herbal adulterants, or other toxin exposures, which includes environmental agents and chemicals.

Source: ajkd.org
Clinical Resource: Journal Article
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Last Checked: 16/03/13 Link Error: Report It

 

How to prevent, recognize, and treat drug-induced nephrotoxicity

In this review, we discuss the common nephrotoxic renal syndromes, the mechanisms of nephrotoxicity of specific commonly used drugs, the associated risk factors for renal injury, and strategies for preventing renal injury.

Source: mdedge.com
Clinical Resource: Journal Article
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Last Checked: 19/06/17 Link Error: Report It

 

Drug-Induced Kidney Injury

It is important to appreciate that a single drug renal toxicity can involve multiple pathophysiologic pathways and that predisposing factors are common to virtually all causative agents mediating kidney injury. Dehydration, hypotension, preexisting kidney disease, advanced age, diabetes and simultaneous use of multiple nephrotoxic drugs all greatly increase risk for any nephrotoxic drug to exert its nephrotoxic effect.

Source: ifcc.org
Clinical Resource: Journal Article
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Last Checked: 16/03/13 Link Error: Report It

 

Aintree University Hospitals NHS
Clinical guidelines to reduce the risk of contrast induced nephropathy

Contrast nephropathy can occur in any patient who receives intravenous or intra-arterial contrast. There are measures available to reduce this complication and should be targeted at those patients who have pre-existing risk factors.

Source: aintreerenalunit.nhs.uk/aintreerenal
Clinical Resource: Guideline
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Last Checked: 16/03/13 Link Error: Report It

 

Frequently Asked Questions About GFR Estimates

Provides concise and direct answers to 23 frequently asked patient questions chosen by physicians about the use of glomerular filtration rate (GFR) in the evaluation of kidney function. Includes several related tables and graphs.

Source: kidney.org
Clinical Resource: Frequently Asked Questions
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Last Checked: 21/08/15 Link Error: Report It

 

Automatic eGFR reporting — its role in screening for kidney disease and drug-dosing decisions

Glomerular filtration rate is the best measure of kidney function | Using MDRD eGFR as a screening tool for chronic kidney disease | Limitations to use of the Cockcroft–Gault or MDRD equation | Using estimates of GFR for drug-dosage adjustments

Source: nps.org.au
Clinical Resource: National Prescribing Service Publication
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Last Checked: 17/02/14 Link Error: Report It

 

Tables for the conversion of serum creatinine to eGFR

Serum creatinine : eGFR conversion table for women
Serum creatinine : eGFR conversion table for men

Source: csnscn.ca
Clinical Resource: Tables
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Last Checked: 16/03/13 Link Error: Report It

 

eGFR Calculator

  • MDRD
  • Cockcroft-Gault
Source: sheffield-kidney-institute.org
Clinical Resource: Calculators
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Last Checked: 16/03/13 Link Error: Report It

 

GFR Calculator (CKD-EPI FORMULA)

The new CKD-EPI formula provides a more precise calculation for the measurement of eGFR, the measurement of kidney function. eGFR is now calculated using the CKD-EPI formula as it improves risk stratification.

Source: kidney.org.au
Clinical Resource: Calculator
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Last Checked: 21/08/15 Link Error: Report It

 

Drug Dosage Adjustment Using Renal Estimation Equations: A Review of the Literature

The purpose of this review is to examine the factors affecting drug clearance and the available evidence for drug dosing based on the CG and the abbrMDRD equations. The important differences and clinical utility of these equations should be appreciated before their use, and these are discussed.

Source: thomasland.com
Clinical Resource: Journal Article
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Last Checked: 26/11/15 Link Error: Report It

 

Drug Dosage Adjustments in Chronic Kidney Disease: The Pharmacist’s Role

An important issue in drug therapy is dosage adjustment in chronic kidney disease (CKD). Many drugs need to be adjusted depending on a person’s kidney function; it is the pharmacist’s duty to ensure a patient is taking the optimal dose.

Source: usask.ca
Clinical Resource: Drug Information Service Newsletter
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Last Checked: 17/02/14 Link Error: Report It

 

Adult Drug Book
Kidney Disease Programme

Source: kdpnet.kdp.louisville.edu
Clinical Resource: Book
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Last Checked: 20/08/15 Link Error: Report It

 

WHO Model Formulary 2008 > Appendix 4: Renal Impairment

Source: who.int
Clinical Resource: Formulary
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Last Checked: 17/02/14 Link Error: Report It

 

Chronic
 Kidney 
Disease
 and 
Drug 
Dosing: 
Information
 for
 Providers


This 
document
 describes 
the 
National
 Kidney 
Disease 
Education 
Program's
(NKDEP) 
suggestions 
and 
rationales 
for 
assessment 
of 
kidney 
function
 for
 drug dosing
 purposes.

Source: nih.gov
Clinical Resource: Factsheet
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Last Checked: 17/02/14 Link Error: Report It

 

Drug use in renal impairment

Dose adjustment in renal impairment
Drugs for which dose adjustment should be considered in patients with renal dysfunction

Source: druginformation.co.nz
Clinical Resource: Guidance
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Last Checked: 17/02/14 Link Error: Report It

 

Nephrology: 3. Safe drug prescribing for patients with renal insufficiency

On average, patients with renal insufficiency are taking at least 7 different medications to manage not only their underlying disease (such as diabetes) but also the symptoms related to their renal impairment (i.e., problems with mineral metabolism, anemia). The frequency of adverse drug reactions increases with the number of medications used, the degree of renal dysfunction, the age of the patient and the number of comorbid conditions.

Source: cmaj.ca
Clinical Resource: Journal Article
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Last Checked: 17/02/14 Link Error: Report It

 

Prescribing in renal disease

The appropriate prescribing of many drugs depends on knowledge of the patient's total renal function, which is proportional to their body mass. The Cockcroft-Gault method of calculating creatinine clearance takes into account the patient's weight. The recently introduced estimated glomerular filtration rate, which is now routinely reported with biochemistry test results, is useful for screening for renal disease, but is unsuitable for calculating doses as it does not take into account the patient's size.

Source: nps.org.au
Clinical Resource: Journal Article
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Last Checked: 08/08/16 Link Error: Report It

 

Using drugs safely in Chronic Kidney Disease

Chronic kidney disease (CKD) affects renal drug elimination and other important processes involved in drug disposition, including absorption, drug distribution and non-renal clearance. As a result, the reduced renal excretion of a drug or its metabolites can cause toxicity and the sensitivity to some drugs is increased even if elimination is unimpaired.

Source: pccj.eu
Clinical Resource: Journal Article
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Last Checked: 17/02/14 Link Error: Report It

 

Know your patient’s renal function – an important prescribing consideration

Know your patient's renal function - an important prescribing consideration discusses medicines that may require renal function monitoring in the general practice setting and highlights the need to assess renal function when prescribing these medicines, especially for older people or for those with diabetes.

Source: veteransmates.net.au
Clinical Resource: Brief
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Last Checked: 17/02/14 Link Error: Report It

 

Do COX-2 inhibitors worsen renal function?

No, COX-2 inhibitors, as a class, do not worsen renal function for those without renal disease. Celecoxib is the only COX-2 inhibitor available, and it is associated with a lower risk of renal dysfunction and hypertension when compared with controls.

Source: jfponline.com
Clinical Resource: Evidence Based Answer to Clinical Question
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Last Checked: 29/10/13 Link Error: Report It

 

Antibiotic doses in renal impairment

Dosing recommendations are based on creatinine clearance calculated using the Cockcroft-Gault equation.

Click on the antibiotic for details of each dose adjustment

Source: gloshospitals.nhs.uk
Clinical Resource: Database
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Last Checked: 17/02/14 Link Error: Report It

 

Guidelines for Antibiotic Dosing in Renal Failure and Dialysis

NOTE: the dosage information in this table is based on Cockgroft -Gault creatinine clearance and not eGFR since the majority of the published information is based on creatinine clearance.

Source: neessexccg.nhs.uk
Clinical Resource: Guideline
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Last Checked: 08/08/16 Link Error: Report It

 

Adult Anti-Infective Dosing Guidelines 2011-2012
NewYork-Presbyterian Hospital

Recommendations for Vancomycin and Aminoglycoside Dosing
Recommendations for Dose Adjustment in Patients With Renal Dysfunction

Source: cumc.columbia.edu
Clinical Resource: Guideline
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Last Checked: 09/03/15 Link Error: Report It

 

Renal Dosage Adjustment Guidelines for Antimicrobials

Source: nebraskamed.com
Clinical Resource: Dosing Protocol
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Last Checked: 17/02/14 Link Error: Report It

 

Antiretroviral Dosing Recommendations in Patients with Renal or Hepatic Insufficiency

Dosing in Renal Insufficiency (Including with chronic ambulatory peritoneal dialysis and hemodialysis)
Dosing in Hepatic Impairment

Source: ashm.org.au
Clinical Resource: Table
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Last Checked: 21/08/15 Link Error: Report It

 

Comprehensive Antiretroviral Table: Adult Dosing, Dosage Form Modifications, Adverse Reactions and Interaction Potential
Renal/Hepatic Dose Adjustments

Source: nccc.ucsf.edu
Clinical Resource: Table
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Last Checked: 25/04/16 Link Error: Report It

 

ARV Renal Dose Adjustments

Source: washington.edu
Clinical Resource: Tables
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Last Checked: 05/01/15 Link Error: Report It

 

Can oseltamivir be used in adult patients with renal impairment?
Prepared by UK Medicines Information (UKMi) pharmacists for NHS healthcare professionals

The manufacturer of oseltamivir revised their dosing recommendations for the use of oseltamivir in patients with renal impairment following a request by the Committee for Medicinal Products for Human Use (CHMP). These changes to the license were based on clinical data from in-house pharmacokinetic studies and modelling and simulation analysis on pharmacokinetics of oseltamivir in patients with varying degrees of renal function.

Source: sps.nhs.uk
Clinical Resource: Medicines Question and Answer
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Last Checked: 22/09/16 Link Error: Report It

 

Can oseltamivir be used in adult patients on renal replacement therapies?
Prepared by UK Medicines Information (UKMi) pharmacists for NHS healthcare professionals

Oseltamivir is licensed for patients undergoing haemodialysis (HD) or peritoneal dialysis (PD). There are few data available regarding the use of oseltamivir in patients receiving other forms of renal replacement therapy (RRT) and reference sources provide conflicting advice. Therefore there is no definitive dose guidance available for these patients.

Source: sps.nhs.uk
Clinical Resource: Medicines Question and Answer
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Last Checked: 22/09/16 Link Error: Report It

 

Enoxaparin in patients with severe renal impairment

There have been a number of medication incidents reported recently involving the use of enoxaparin in patients with severe renal impairment (creatinine clearance less than 30ml/min) who, as a result of treatment have suffered a haemorrhage.

Source: medicinesgovernance.hscni.net
Clinical Resource: Memo
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Last Checked: 31/03/14 Link Error: Report It

 

Can patients with renal impairment take glucosamine?
Prepared by UK Medicines Information (UKMi) pharmacists for NHS healthcare professionals

Glucosamine is available in a variety of over-the-counter dietary supplements and as licensed prescription only medicines, therefore quality and content varies between products. Little information is available about herbs and dietary supplements in patients with renal impairment.

Source: sps.nhs.uk
Clinical Resource: Medicines Question and Answer
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Last Checked: 22/09/16 Link Error: Report It

 

What are the differences among modes of renal replacement therapy?

Source: uic.edu
Clinical Resource: Frequently Asked Question
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Last Checked: 04/12/15 Link Error: Report It

 

AEDS - Risk of Drug Removal by Hemodialysis

Source: epilepsy.com
Clinical Resource: Table
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Last Checked: 08/04/14 Link Error: Report It

 

Treatment of Hypertension in Dialysed Patients
European Society of Hypertension Newsletter

Hypertension is common in dialysed patients (>80% at pre-dialysis state, >60% in patients with hemodialysis, >30 percent in those with peritoneal dialysis). The leading cause of death in dialysed patients is cardiovascular.

Source: eshonline.org
Clinical Resource: Newsletter
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Last Checked: 19/08/15 Link Error: Report It

 

Blood Pressure Targets For Patients With Chronic Kidney Disease
European Society of Hypertension Newsletter

Hypertension is a major risk factor for the development and progression of chronic kidney disease (CKD) and can also be a consequence of kidney injury.

Source: eshonline.org
Clinical Resource: Newsletter
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Last Checked: 19/08/15 Link Error: Report It

 

A Review of Critical Differences Among Loop, Thiazide, and Thiazide-Like Diuretics

This article reviews the general renal transport mechanisms of diuretics and compares and contrasts loop, thiazide, and thiazide-like diuretics.

Source: thomasland.com
Clinical Resource: Journal Article
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Last Checked: 28/11/16 Link Error: Report It

 

Renin–Angiotensin-Aldosterone System Blockade in Hypertensive Patients with Chronic Kidney Disease
European Society of Hypertension Newsletter

In this report we discuss evidence from trials with hard renal end-points attempting to clarify the value of RAAS blockade for different types of hypertensive patients with CKD.

Source: eshonline.org
Clinical Resource: Newsletter
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Last Checked: 19/08/15 Link Error: Report It

 

Angiotensin-II receptor antagonists: what is the evidence for their place in therapy?

ACE inhibitors and A2RAs are used in a wide range of indications including hypertension, heart failure, treatment post-myocardial infarction (MI), diabetes and chronic kidney disease (CKD). Prescribing can either be with an ACE inhibitor alone, an A2RA alone or, in some limited circumstances, combination therapy with an ACE inhibitor plus an A2RA.

Source: webarchive.org.uk
Clinical Resource: National Prescribing Centre Publication
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Last Checked: 24/04/15 Link Error: Report It

 

ACE inhibitors and ARBs: One or the other—not both—for high-risk patients
The combination of an ACE inhibitor and an ARB reduces proteinuria, but leads to worse renal outcomes

Avoid prescribing an angiotensin-converting enzyme (ACE) inhibitor and an angiotensin receptor blocker (ARB) for patients at high risk of vascular events or renal dysfunction. The combination does not reduce poor outcomes, and leads to more adverse drug-related events than an ACE inhibitor or ARB alone.

Source: jfponline.com
Clinical Resource: Journal Article
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Last Checked: 29/10/13 Link Error: Report It

 

Cross-Reactivity of ACE Inhibitor–Induced Angioedema with ARBs

Angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme (ACE) inhibitors are highly utilized classes of medications that affect the renin-angiotensin-aldosterone system (RAAS). Both have been shown to be beneficial in the treatment of disease states--such as hypertension, chronic heart failure, chronic kidney disease, and myocardial infarction--in which the RAAS system plays a significant role.

Source: uspharmacist.com
Clinical Resource: Journal Article
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Last Checked: 15/04/14 Link Error: Report It

 

Can angiotensin receptor blockers (ARBs) be administered to patients who develop angioedema on angiotensin-converting enzyme inhibitor (ACEI) therapy?

Source: uic.edu
Clinical Resource: Frequently Asked Question
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Last Checked: 04/12/15 Link Error: Report It

 

National Institute for Health and Care Excellence (NICE) Guidance >Anaemia management in people with chronic kidney disease

Source: nice.org.uk
Clinical Resource: Guidance
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Last Checked: 18/05/15 Link Error: Report It

 

BC Provincial Renal Agency
Anemia Management Protocol

Source: bcrenalagency.ca
Clinical Resource: Protocol
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Last Checked: 30/12/13 Link Error: Report It

 

The Tayside Diabetes Handbook - Screening and Management of Kidney Complications

What is Microalbuminuria & Proteinuria
Screening for Nephropathy
Urine testing""- what samples are needed?
What other tests should be done
Interpreting the results
eGFR
Investigation of CKD in People with Diabetes - Flow Chart
Management of Diabetic Renal Disease
Guidance on use of Metformin in diabetic patients with CKD
Guidelines for the Combined Diabetes Renal Clinic at Ninewells Hospital

Source: diabetes-healthnet.ac.uk
Clinical Resource: Handbook
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Last Checked: 30/08/16 Link Error: Report It

 

Urine Albumin-to-Creatinine Ratio (UACR)

Evaluating Patients with Diabetes for Kidney Disease presents key information about assessing UACR and GFR for diabetes educators and other healthcare professionals.

Source: nih.gov
Clinical Resource: Factsheet
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Last Checked: 17/02/14 Link Error: Report It

 

Management of hyperglycemia in patients with diabetes mellitus and chronic renal failure

Diabetes mellitus is recognized as a leading cause of chronic kidney disease and end-stage renal failure. Chronic renal failure is associated with insulin resistance and, in advanced renal failure, decreased insulin degradation. Both of these abnormalities are partially reversed with the institution of dialysis. Except for diet with protein restriction, patients with diabetes should be preferably treated with insulin.

Source: nih.gov
Clinical Resource: Journal Article
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Last Checked: 16/03/13 Link Error: Report It

 

Management of Gout in the Presence of Chronic Kidney Disease

The purpose of this newsletter is to provide direction on the management of gout in patients with CKD, including pertinent updates from the new guidelines.

Source: oregonstate.edu
Clinical Resource: Newsletter
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Last Checked: 19/08/15 Link Error: Report It

 

Managing gout: How is it different in patients with chronic kidney disease?

In this paper, we discuss approaches to and controversies in the management of gout and hyperuricemia in patients with CKD. Unfortunately, the evidence from clinical trials to guide treatment decisions is limited; therefore, decisions must often be based on experience and pathophysiologic principles.

Source: mdedge.com
Clinical Resource: Journal Article
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Last Checked: 19/06/17 Link Error: Report It

 

 

Osteoporosis and Chronic Kidney Disease

This issue of “Osteoporosis Clinical Updates” provides tools and suggestions for identifying those CKD patients who would benefit from treatment for osteoporosis in a general practice setting and who would be better served by referral to a specialist with experience in renal-related bone disease.

Source: nof.org
Clinical Resource: Update
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Last Checked: 20/08/15 Link Error: Report It

 

Bisphosphonate prescribing in chronic kidney disease

Bone disease is commonly associated with chronic kidney disease (CKD), and the prevalence of skeletal abnormalities in those with end-stage renal disease approaches 100%. While renal osteodystrophy is the collective term for various types of uraemia-related bone remodelling, including hyperparathyroid bone disease, adynamic bone disease and osteomalacia, persons with CKD can also develop osteoporosis.

Source: rcpe.ac.uk
Clinical Resource: Journal Article
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Last Checked: 17/02/14 Link Error: Report It

 

 

Pharmacology, Efficacy, and Safety of Oral Phosphate Binders

Oral phosphate binders are required by the majority of patients on dialysis, and all of these binders can control serum levels of phosphate to similar degrees. Patient preference and adherence to prescribed therapy is at least as important as the efficacy of the prescribed binder. Avoidance of calcium-containing binders has become accepted practice where the alternatives are affordable, but incontrovertible evidence in favor of this approach is lacking.

Source: medscape.org
Clinical Resource: CE / CPD / CME / Learning
Register to Access Content: Yes - registration is FREE

Last Checked: 16/03/13 Link Error: Report It

 

Nutrition in Renal Failure: Myths and Management

This article reviews factors that frequently impair nutrition status in patients with renal failure, and provides suggestions for diet, supplements, and specialized nutrition support. Nutrition assessment, monitoring, and guidelines for vitamin and mineral supplements are discussed.

Source: virginia.edu
Clinical Resource: Journal Article
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Last Checked: 25/04/16 Link Error: Report It

 

Nutritional Support for Patients with Acute Kidney Injury: How Much Protein is Enough or Too Much?

This review will focus on nutrient metabolism in AKI as well as provide an in-depth focus on the provision of nutritional support in this vulnerable population. It is only through a comprehensive therapeutic plan including nutritional support that the mortality associated with AKI can be attenuated.

Source: virginia.edu
Clinical Resource: Journal Article
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Last Checked: 25/04/16 Link Error: Report It

 

Expert Working Group report on nutrition in adult patients with renal insufficiency (part 1 of 2)

The paper has therefore been divided into two parts. The first part examines the prevalence, effects and mechanisms responsible for the development of protein-energy malnutrition in uraemic patients; the tools currently available for assessing nutritional status; the possible effects of the diet on the progression of kidney disease; the nutritional problems of patients with chronic renal failure in the pre-dialytic period.

Expert working group report on nutrition in adult patients with renal insufficiency (Part 2 of 2)

The second part of the report deals with the nutritional therapy of 1) patients with chronic renal failure on haemodialytic treatment or peritoneal dialysis, 2) patients with nephrotic syndrome, 3) patients with acute renal failure and 4) kidney transplanted patients.

Source: espen.org
Clinical Resource: Working Group Report
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Last Checked: 16/03/13 Link Error: Report It

 

European Society for Clinical Nutrition and Metabolism Guidelines on Parenteral Nutrition: Adult Renal Failure

Source: espen.org
Clinical Resource: Guideline
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Last Checked: 16/03/13 Link Error: Report It

 

Leicestershire Medicines Strategy Group Guideline
Leicestershire Statement on the use of Generic Immunosuppressants in people following Renal Transplantation

Source: lmsg.nhs.uk
Clinical Resource: Guideline
Register to Access Content: No

Last Checked: 11/04/16 Link Error: Report It

 

Generic Immunosuppressants in the Specialist Area of Transplantation – Consensus on Implications and Practical Recommendations
Efficacy and Safety of PRescribing In Transplantation

Source: esprit.org.uk
Clinical Resource: Consensus Document
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Last Checked: 22/11/16 Link Error: Report It

 

ESPRIT Ciclosporin-Specific Resources

Following the introduction of alternative formulations of ciclosporin into the UK, please find below some materials that will help to communicate the potential complications that could result if a patient were inadvertently switched between ciclosporin brands.

ESPRIT Prescribing Recommendations (Extended)
ESPRIT Prescribing Recommendations (Summary)
Patient Letter
GP Letter
Transplant Clinic Poster
Patient Leaflet
Treatment Reminder Card

Source: esprit.org.uk
Clinical Resource: Various
Register to Access Content: No

Last Checked: 25/11/13 Link Error: Report It

 

American Society of Hypertension Position Paper
Management of hypertension in the transplant patient

Source: ash-us.org
Clinical Resource: Position Paper
Register to Access Content: No

Last Checked: 25/06/13 Link Error: Report It

 

Treatment of UTIs in patients with renal failure

What is the treatment of choice for a urinary tract infection (UTI) in a patient with renal failure?

Source: druginformation.co.nz
Clinical Resource: Drug Information Service Bulletin
Register to Access Content: No

Last Checked: 16/03/13 Link Error: Report It

 

 

Queensland Tuberculosis Control Centre Guidelines for Treatment of Tuberculosis in Patients with Renal Disease

Source: health.qld.gov.au
Clinical Resource: Guideline
Register to Access Content: No

Last Checked: 21/08/15 Link Error: Report It

 

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