Nutrition
Diet and medication therapy for kidney stones
As a nephrology pharmacy specialist, you will get questions about how to prevent kidney stones. Calcium stones especially calcium oxalate stones, account for about 80% of kidney stones. And about 50% of patients with a first kidney stone will have another within 5 years without any treatment. NUTRITIONAL AND DIETARY THERAPIES Emphasize dietary changes first.…
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Pain Management
Management of pain in patients with renal insufficiency or end-stage renal disease on dialysis
Overview ㅡ Pain is a common problem in patients with renal insufficiency and end-stage renal disease (ESRD) and can have a significant effect on the patient’s quality of life. When assessing a patient’s pain, assess both the severity of the pain (such as on an analogue scale, 0-10) and the characteristics of the pain ( see figure 1 ). Pain is most commonly characte…
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Renal Function
Don't use estimated GFR to renally dose all medications
The debate continues about whether to use creatinine clearance (CrCl) or estimated glomerular filtration rate (eGFR) for renal dosing. We used to just use the Cockcroft-Gault equation to calculate CrCl for renal dosing. But there's an increase in using eGFR calculated by the Modification of Diet in Renal Disease (MDRD) equation , such as in dosing recommen…
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Nephrology and Urology
Diagnosis of acute kidney injury (AKI)
OVERVIEW — Acute kidney injury (AKI) is a term covering a spectrum of injury to the kidneys which can result from a number of causes. It is a clinical syndrome rather than a biochemical diagnosis. The term "acute kidney injury" has replaced the concept of acute renal failure as it more accurately describes that injury to the kidney can occur before functio…
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Pain Management
Kidney risks of non-steroidal anti-inflammatory drugs (NSAIDs)
As a pharmacist, you will see more focus on the kidney risks of non-steroidal anti-inflammatory drugs (NSAIDs). Some government and medical groups are now educating providers to avoid giving NSAIDs to patients at risk for kidney problems. Think about a patient's risk before suggesting an NSAID. It's usually okay for patients with …
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