Prescribing and deprescribing in chronic kidney disease
Jo-Anne Manski-Nankervis, Rita McMorrow, Craig Nelson, Shilpanjali Jesudason, Janet K Sluggett
AUSTRALIAN JOURNAL OF GENERAL PRACTICE | ROYAL AUSTRALIAN COLLEGE GENERAL PRACTITIONERS | Published : 2021
BACKGROUND: Chronic kidney disease (CKD) rarely occurs in isolation; multimorbidity is the norm. As a result, polypharmacy is common in people with CKD. Some medications are indicated to reduce the risk of cardiovascular disease and progression of CKD. In contrast, some medications may require dose reduction or cessation as a result of advancing stages of CKD. OBJECTIVE: The aim of this article is to describe broad principles of managing the challenges and necessities of polypharmacy in patients with CKD. DISCUSSION: Medications such as angiotensin converting enzyme inhibitors, angiotensin receptor blockers, statins and sodium-glucose co-transporter-2 inhibitors may reduce cardiovascular dis..View full abstract
JMN is supported by a Medical Research Future Fund (MRFF) Next Generation Clinical Researchers Program -TRIP Fellowship (APP1168265). RM reports grants from Australian Rotary Health PhD Scholarship, during the conduct of the study. JKS is supported by a National Health and Medical Research Council (NHMRC) Early Career Fellowship (grant number APP1156439). JKS has received research grants and/or consultancy funds from the NHMRC Cognitive Decline Partnership Centre, MRFF, Dementia Australia Research Foundation, Yulgilbar Foundation, AAG Research Trust, Dementia Centre for Research Collaboration, Australian Academy of Science, Australian Government Aged Care Quality Agency, Australian Association of Consultant Pharmacy Pty Ltd, and the Pharmaceutical Society of Australia. JKS is a pharmacist accredited to perform collaborative medication reviews.