Caring for Patients with Chronic Kidney Disease: A Joint Opinion of the Ambulatory Care and the Nephrology Practice and Research Networks of the American College of Clinical Pharmacy

Abstract

An increasing number of patients are developing chronic kidney disease (CKD). Appropriate care for patients with CKD must occur in the earliest stages, preferably before CKD progresses to more severe stages. Therefore, recognition and treatment of CKD and its associated complications must occur in primary care settings. Patients with CKD often have comorbid conditions such as diabetes mellitus, hypertension, and dyslipidemia, creating specific considerations when treating these diseases. Also, these patients have CKD-related conditions, including anemia and renal osteodystrophy, that are not traditionally evaluated and monitored by the primary care practitioner. Collectively, many opportunities exist for pharmacists who practice in the primary care setting to improve the care of patients with CKD.

Potentially Preventable Hospitalization as a Complication of CKD: A Cohort Study

“…15 For these reasons, there is substantial interest in using high-quality ambulatory care to prevent hospitalization in people with CKD. 16 Efforts to achieve this objective have been hampered by an inability to distinguish potentially preventable from nonpreventable causes of hospitalization and by lack of information about the clinical characteristics that make the former more likely. In this large population-based study of more than 2 million adults (.200,000 with CKD), we investigated the frequency of 4 types of potentially preventable hospitalizations and identified the characteristics of those who were more likely to experience such hospitalizations.…”

Improving the Management of Chronic Kidney Disease in Uruguay: A National Renal Healthcare Program

“…Nephrologists cannot care for all CKD patients, and the prevention and early detection of this disease requires a skilled, multidisciplinary primary care team and a coordinated approach [11]. In order to attain such care, different strategies have been published based on the healthcare system and the living standards of various countries [12,13,14,15,16,17,18,19,20,21,22,23,24,25]. …”

Standards of Clinical Practice for Renal Pharmacists

“…1 Patients with stage 1 to 5 CKD and those undergoing dialysis are at extremely high risk for drug therapy problems (DTPs). 2,3 In controlled trials involving general patient populations, clinical pharmacist interventions have reduced hospital admissions, length of hospital stay, readmissions, and emergency department visits. [4][5][6][7] The activities of pharmacists most strongly associated with improved patient outcomes include participating on rounds, interviewing patients, performing medication reconciliation, counselling patients on discharge, and conducting postdischarge followup.…”