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Renal therapeutics: part two

Introduction
Understanding ADME
High-risk medicines
Medicine accumulation
Review
Medication to avoid
Dialysis and transplant patients

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Patients should be reviewed before receiving medication if they have a renal impairment. Pharmacy professionals can:

  • Check the customer’s medication history and ask about other medications they may use
  • Check use of recreational drugs 
  • Consider withholding nephrotoxic medications on admission in patients at high risk of AKI, e.g. NSAIDs
  • Consider temporarily withholding medicines which are not nephrotoxic but which can compromise renal function in already damaged kidneys, e.g. ACE inhibitors
  • Ensure that all doses are amended according to the patient’s degree of renal impairment. Re-assess daily until the episode of AKI resolves
  • Before discharge discuss with the patient any medications that have been withheld during the AKI episode and ensure they know if and when they need to restart
  • Discuss medicines to avoid in future and outline sick day guidance
  • Ensure information is passed on to the GP about which medicines are being restarted and when.

    • Renal therapeutics: part two

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