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Renal care

Prescribing in patients with kidney disease

02 October 2020
Better Practice
02 October 2020
Volume 2 · Issue 10

Abstract

This article aims to support healthcare professionals from all care sectors when making prescribing decisions in patients with kidney disease. The authors discuss which renal dosing equation to use on a case-by-case basis and provide some background to common medicines prescribed for kidney patients. When discussing patients with chronic kidney disease, acute kidney injury and kidney transplants, commonplace prescribing issues that can be avoided are highlighted. It is hoped that raising awareness of prescribing in kidney patients can ensure these patients have a better experience and outcome from their treatment.

With up to 25% of hospital inpatients developing an acute kidney injury (Challiner et al, 2014) and approximately three million people with chronic kidney disease (CKD), there are an increasing number of kidney patients in daily practice (Public Health England, 2014). The kidney has important physiological roles, and when kidney function is impaired, numerous medications may be required to manage kidney-related problems. Medication review is required to ensure drug-related issues are not contributing to decline in kidney function, and with the major role the kidney plays in drug excretion, careful consideration needs to be given to choice and dosing of drug therapies. Recently, the Medicines And Healthcare Regulatory Agency (gov.uk, 2019) issued guidance on renal dosing of drugs, because of confusion over which method should be used to calculate renal function.

This paper encompasses areas of kidney disease where prescribing decisions are encountered on a regular basis in both primary and secondary care, with discussion of common medications and practical advice to support the management of these complex patients.

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Chronic kidney disease
acute kidney injury
kidney transplant
renal drug dosing
renal drugs