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Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

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Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
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Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

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In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
128
Acute Kidney Injury VI: Nursing Management01:22

Acute Kidney Injury VI: Nursing Management

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Acute Kidney Injury (AKI) results in an inability to maintain fluid, electrolyte, and acid-base balance. Effective nursing management is critical in improving patient outcomes and includes comprehensive patient assessment and targeted interventions.Comprehensive Patient AssessmentA detailed history collection is essential, focusing on any recent infections, nephrotoxic medication use, or chronic conditions such as hypertension and diabetes that may contribute to AKI. During the physical...
45
Antihypertensive Drugs: Potassium-Sparing Diuretics01:28

Antihypertensive Drugs: Potassium-Sparing Diuretics

680
Liddle syndrome is a genetically inherited form of hypertension characterized by the overactivity of epithelial sodium channels in the nephron, the functional unit of the kidney. This heightened activity leads to increased sodium reabsorption and excessive excretion of potassium. To counteract this, potassium-sparing diuretics such as amiloride are used. They function by blocking these sodium channels, thereby reducing the influx of sodium into the epithelial cells and minimizing the loss of...
680
Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

67
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
67
Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

445
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
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Potassium management with finerenone: Practical aspects.

Christoph Wanner1, Paola Fioretto2, Csaba P Kovesdy3

  • 1Medical University of Würzburg, Würzburg, Germany.

Endocrinology, Diabetes & Metabolism
|December 27, 2022
PubMed
Summary

Finerenone effectively improves cardiorenal outcomes in patients with type 2 diabetes and chronic kidney disease. While it increases hyperkalemia risk, careful potassium monitoring ensures safe use and prevents adverse events.

Keywords:
chronic kidney diseasediabetesfinerenonehyperkalemiapotassium

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Area of Science:

  • Nephrology
  • Cardiology
  • Endocrinology

Background:

  • Finerenone, a selective nonsteroidal mineralocorticoid receptor antagonist, demonstrates positive cardiorenal effects.
  • It is indicated for patients with chronic kidney disease (CKD) and type 2 diabetes (T2D).

Purpose of the Study:

  • To highlight the necessary potassium management for finerenone use.
  • To provide practical recommendations for safe finerenone administration.

Main Methods:

  • Evaluation of finerenone's clinical outcomes in two large randomized trials: FIDELIO-DKD (renal) and FIGARO-DKD (cardiovascular).
  • Analysis of hyperkalemia incidence and management strategies in trial participants.

Main Results:

  • Patients on finerenone showed a significantly higher incidence of hyperkalemia compared to placebo.
  • Treatment discontinuation due to hyperkalemia was low, with no deaths attributed to it.
  • Structured potassium monitoring, dose adjustments, and temporary interruptions were key to safe management.

Conclusions:

  • Routine potassium monitoring is essential for the safe use of finerenone.
  • Finerenone can be safely administered to protect the kidneys and cardiovascular system in patients with albuminuric CKD and T2D when managed properly.