Information and consensus document for the detection and management of chronic kidney disease

García-Maset, Rafael; Bover, Jordi; Morena, J. Segura de la; Diezhandino, Marian Goicoechea; Hoyo, J. Cebollada del; Martín, Javier Escalada San; Fácila, Lorenzo; Ortiz, Javier Gamarra; García-Donaire, José Antonio; García-Matarín, L; Garcia, Sílvia Gràcia; Pérez, María Isabel Gutiérrez; Moreno, Julio Hernández; Ramos, Pilar Mazón; Bermúdez, Rosario Montañés; Torres, Manuel Muñoz; Pablos-Velasco, Pedro de; Pérez-Maraver, Manuel; Fernández, Carmen Suárez; Iparraguirre, Salvador Tranche; Górriz, José Luis

doi:10.1016/j.nefroe.2022.07.003

Cited by 13 publications

(3 citation statements)

References 135 publications

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“…Regular monitoring of kidney function, electrolyte levels, and urinary calcium excretion is crucial for detecting any complications early, evaluating the effectiveness of the treatment, and identifying any progression of nephrocalcinosis[ 104 ]. Nephrocalcinosis can increase the likelihood of developing kidney stones, so preventive measures like dietary adjustments, increased fluid intake, and medication (such as potassium citrate) may be advised[ 66 ].…”

Section: Discussionmentioning

confidence: 99%

Renal calcification in children with renal tubular acidosis: What a paediatrician ‎should ‎know‎

Al-Beltagi,

Saeed,

Bediwy

et al. 2023

World J Clin Pediatr

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Renal tubular acidosis (RTA) can lead to renal calcification in children, which can cause various complications and impair renal function. This review provides pediatricians with a comprehensive understanding of the relationship between RTA and renal calcification, highlighting essential aspects for clinical management. The article analyzed relevant studies to explore the prevalence, risk factors, underlying mechanisms, and clinical implications of renal calcification in children with RTA. Results show that distal RTA (type 1) is particularly associated with nephrocalcinosis, which presents a higher risk of renal calcification. However, there are limitations to the existing literature, including a small number of studies, heterogeneity in methodologies, and potential publication bias. Longitudinal data and control groups are also lacking, which limits our understanding of long-term outcomes and optimal management strategies for children with RTA and renal calcification. Pediatricians play a crucial role in the early diagnosis and management of RTA to mitigate the risk of renal calcification and associated complications. In addition, alkaline therapy remains a cornerstone in the treatment of RTA, aimed at correcting the acid-base imbalance and reducing the formation of kidney stones. Therefore, early diagnosis and appropriate therapeutic interventions are paramount in preventing and managing renal calcification to preserve renal function and improve long-term outcomes for affected children. Further research with larger sample sizes and rigorous methodologies is needed to optimize the clinical approach to renal calcification in the context of RTA in the pediatric population.

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Section: Discussionmentioning

confidence: 99%

Renal calcification in children with renal tubular acidosis: What a paediatrician ‎should ‎know‎

Al-Beltagi,

Saeed,

Bediwy

et al. 2023

World J Clin Pediatr

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show abstract

“…Treatment consists of protecting the kidney by controlling the complications that may arise and the risk factors that can aggravate the disease, especially hypertension and diabetes [ 12 ]. In addition, identifying and managing nephrotoxic drugs in stage 3 CKD, ( Table 1 ) and discontinuing them in stages 4–5 [ 11 – 13 ] is important.…”

Section: Introductionmentioning

confidence: 99%

“…This includes adjusting the dose of drugs based on eGFR to avoid further nephrotoxicity, or potential overdosing due to decreased kidney clearance [13][14][15]. Studies have shown that up to 52% of patients who need some adjustments are detected [14].…”

Section: Introductionmentioning

confidence: 99%

Pharmaceutical care program for patients with chronic kidney disease in the community pharmacy: Detection of nephrotoxic drugs and dose adjustment. Viability study

Escribá-Martí¹,

Cámara-Ramos

Climent-Catalá³

et al. 2022

PLoS ONE

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Introduction Chronic kidney disease (CKD) is a major health problem. Early detection is the key to reducing morbidity and mortality, but it is difficult because it occurs without symptoms. Diagnosis of CKD is also important to avoid nephrotoxic drugs and to adjust the doses of other medications that may be affected. Pharmacies, due to their proximity to the population, frequency of patient visits, and knowledge of medication use are an ideal location for point-of-care diagnosis or CKD. Objective To detect and refer to the primary care physician patients with low estimated glomerular filtration rate (eGFR) who use nephrotoxic drugs or who may require a dose adjustment. Methodology Pharmacy users over 60 years of age who agreed to participate were given a creatinine/eGFR test with a point-of-care meter. The eGFR was calculated and if it was less than 60 ml/min/1.73 m2, their medications were evaluated to identify nephrotoxic drugs or drugs that potentially required adjustment. If either were found, they were referred to their doctor for further management. Results 198 patients were recruited in 4 pharmacies, of which 87 (43.9%) had an eGFR less than 60 ml/min/1.73 m2. They were taking a total of 635 medications. Of these 635 medications, 50 (7.9%) were affected by kidney function. Dose adjustment was recommended in 31 and discontinuation in 19. The primary care doctor accepted the recommendations for 14 medications: dose adjustment for 6 and withdrawal in 8. This represents 2.3% of medications taken by patients with an eGFR less than 60 ml/min/1.73 m2. The 50 medications identified were taken by 29 patients (33.3% of the 87 with a low eGFR) and a change in treatment was generated in 9 patients, representing 4.6% of the total number of patients in the sample, and 10% of the patients with a low eGFR. Conclusion Point-of-care testing for kidney function in a pharmacy setting is feasible and identifies a significant number of patients with eGFR under 60 ml/min/1.73 m2. It also allows for appropriate medication management recommendations in this patient group.

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¿Es apropiada la aplicación de la nueva ecuación Chronic Kidney Disease Epidemiology Consortium (CKD-EPI 2021) en la población española?

Escribano‐Serrano

Jiménez-Varo

Escribano-Cobalea

et al. 2023

Revista Clínica Española

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Information and consensus document for the detection and management of chronic kidney disease

Cited by 13 publications

References 135 publications

Renal calcification in children with renal tubular acidosis: What a paediatrician ‎should ‎know‎

Renal calcification in children with renal tubular acidosis: What a paediatrician ‎should ‎know‎

Pharmaceutical care program for patients with chronic kidney disease in the community pharmacy: Detection of nephrotoxic drugs and dose adjustment. Viability study

¿Es apropiada la aplicación de la nueva ecuación Chronic Kidney Disease Epidemiology Consortium (CKD-EPI 2021) en la población española?

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