Slowing Chronic Kidney Disease Progression
These modules address chronic kidney disease assessment and management with a focus on patients with advanced chronic kidney disease (CKD, stages 4-5) and the intersection of CKD and heart disease.
Overall Course Objectives
By the end of this course, learners will be able to: 1. Adopt patient-centered medication management strategies to address CKD progression in the context of a multidisciplinary team using the pharmacist patient care process framework (collect, assess, plan, implement, monitor and evaluate, and document activities). 2. Assess kidney function for staging CKD and drug dosing using contemporary methods for estimating glomerular filtration rate with consideration of the utility and limitations of each method. 3. Design prevention, treatment, and patient education strategies for slowing chronic kidney disease progression that incorporate evidence-based pharmacologic and nonpharmacologic treatment. 4. Create care plans that address disparities in CKD to achieve pharmacoequity. 5. Construct strategies to address the common clinical controversies in the management of cardiometabolic complications in a patient with CKD to optimize medication management. 6. Describe barriers to medication adherence and facilitate strategies to improve medication adherence in patients with CKD. 7. Initiate appropriate deprescribing measures to reduce medication burden and/or harm in patients with kidney disease. 8. Identify and prioritize opportunities for pharmacists to optimize health care and provide comprehensive medication management (CMM) for patients in value-based payment systems. *Cases will be used throughout to provide application-based learning opportunities.
Course Modules
This module addresses the shifting landscape of cardiovascular risk factors-specifically the rising epidemics of obesity, chronic kidney disease (CKD), and type 2 diabetes-and explores how an interdisciplinary approach can manage serum potassium levels without sacrificing life-saving, disease-modifying therapies.
Estimated glomerular filtration rate (eGFR) equations are used for kidney disease staging, to assess kidney disease progression, and drug dosing. Which equation to use is a controversial area. This module will discuss the newest equations that removed race as a variable. This module focuses on the basis for these changes, compares accuracy of these new equations to the older equations and demonstrates the rationale for using non-indexed results from this new equation for drug-related decision making.
This is an important topic for pharmacists and health care providers who see people with kidney disease. This module will cover the evaluation of kidney function part 2, focusing on the application of the race-agnostic eGFR equation to stage Chronic Kidney Disease, evaluate when evidence-based medication therapy is warranted and determine a drug dosing regimen. It is recommended to review Evaluation of Kidney Function – Part 1: Use of Race-Agnostic eGFR before taking this module.
Patients with chronic kidney disease are often prescribed numerous medications to treat comorbidities, slow the progression of their kidney disease, and to minimize morbidity and mortality. These complex medication regimens lead to an increased potential for medication therapy problems. This module discusses common medication therapy problems associated with chronic kidney disease, medication reconciliation for this population, and the contributions that pharmacists can provide in medication therapy management. By the end of this module, learners will be able to: Identify medications that can accelerate kidney function decline both acutely and chronically Define prescribing cascades and determine when it is appropriate to deprescribe medications in patients with CKD to minimize pill burden and potential for adverse events Utilize a medication financial assistance tool to improve patient access to guideline directed medication therapy Develop a plan to address medication therapy problems given a patient case
A majority of medications are primarily eliminated by the kidneys. As kidney function declines in chronic kidney disease, altered pharmacokinetics necessitate dosage adjustment to minimize toxicity risk while ensuring optimal efficacy. This module will provide the underpinning pharmacokinetic rationale for these medication dosage adjustments, using practical examples of commonly used medications in clinical practice. By the end of this module, learners will be able to: Describe clinically relevant changes in pharmacokinetics (PK) and pharmacodynamics (PD) that occur as kidney function declines. Differentiate data derived from PK studies and outcomes studies to make drug therapy decisions. Design a medication regimen and monitoring plan for high-risk medications in patients with chronic kidney disease (CKD). Design strategies to engage patients and caregivers in the design of their medication regimen to promote efficacy and safety.
COMING SOON
The prevalence of Chronic Kidney Disease (CKD) is rising in the United States. National efforts have been implemented to improve the quality of care and outcomes of people with CKD. For the first time in decades, there are exciting new therapies available that have been proven to slow the progression of CKD. This module on Chronic Kidney Disease and Management will discuss the evaluation of kidney function, management of CKD and opportunities for Pharmacists; and you will apply concepts to a patient case. By the end of this module, learners will be able to: Asses Kidney Function Describe Chronic Kidney Disease (CKD) and its epidemiology Describe management of CKD Define value-based Care Identify opportunities for Pharmacists
COMING SOON
Value-based care has the potential to revolutionize the way pharmacists practice. The success of value-based programs are contingent upon patient outcomes, which are often influenced by the medication therapy problems. Thus, pharmacists are well positioned to be key members of value-based care teams to address complex medication therapy problems in patients with CKD. Value-based kidney care is in its infancy, so it is vital for the pharmacy workforce to be prepared and integrate into these programs. By the end of this module, learners will be able to: Describe value-based models of care in nephrology practice Identify opportunities for pharmacists to provide patient centered CMM to patients with CKD Utilize reimbursement strategies to integrate a pharmacist into nephrology practices to optimize medication management in patients with CKD