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Related Concept Videos

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...
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Nephrons01:10

Nephrons

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The kidneys are intricate organs with millions of working units known as nephrons. Each nephron features two major structures: the renal corpuscle, which facilitates blood plasma filtration, and the renal tubule, which handles the glomerular filtrate. Blood supply is directly linked to the nephrons. The renal corpuscle consists of the glomerulus, a capillary network, and the Bowman's capsule, a double-walled epithelial structure that encases the glomerulus. The filtering of blood plasma...
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Factors Affecting Renal Clearance: Renal Impairment01:17

Factors Affecting Renal Clearance: Renal Impairment

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Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
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Dialysis01:27

Dialysis

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Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
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Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

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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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Renal Drug Excretion: Tubular Secretion01:28

Renal Drug Excretion: Tubular Secretion

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Active tubular secretion is a robust, energy-demanding process that utilizes carrier systems to transport drugs into renal tubules. The active renal secretion systems include the organic anion transporter (OAT) for weak acids and the organic cation transporter (OCT) for weak bases. Structurally similar drugs can compete for the same transporter, potentially leading to drug accumulation and toxicity. However, this principle can be exploited therapeutically. One example is probenecid (Probalan),...
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5/6 Nephrectomy Using Sharp Bipolectomy Via Midline Laparotomy in Rats
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Updates in Chronic Kidney Disease.

Haley N Johnson1, Lalita Prasad-Reddy2

  • 1Pharmacy Practice, St. Louis College of Pharmacy at University of Health Sciences and Pharmacy, St. Louis, MO, USA.

Journal of Pharmacy Practice
|June 15, 2024
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Summary
This summary is machine-generated.

Effective chronic kidney disease (CKD) management requires strict blood glucose and blood pressure control. Recent advancements offer new therapies for CKD progression and complications like anemia.

Keywords:
ambulatory carechronic kidney diseasediabetic kidney diseaseinternal medicinenephrology

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Area of Science:

  • Nephrology
  • Internal Medicine
  • Pharmacology

Background:

  • Chronic kidney disease (CKD) impacts 14% of US adults and 10% globally.
  • Blood glucose and blood pressure control are primary prevention strategies for CKD.
  • Emerging therapies address CKD progression and complications such as anemia.

Purpose of the Study:

  • To review recent evidence and approved agents for CKD evaluation and management.
  • To provide updated guidance on managing CKD complications.
  • To support healthcare professionals, particularly pharmacists, in CKD patient care.

Main Methods:

  • Review of glomerular filtration rate (GFR) measurement methods (CKD-EPI 2021, cystatin C).
  • Analysis of Kidney Disease Improving Global Outcomes (KDIGO) and American Diabetes Association (ADA) guidelines.
  • Inclusion of primary literature on newer CKD agents and CMS coverage.

Main Results:

  • Newer agents, including mineralocorticoid receptor antagonists and HIF-PH inhibitors, show promise.
  • Updated guidelines and measurement methods aid in precise CKD evaluation.
  • Checklists are provided for managing blood pressure, blood glucose, CKD-mineral bone disorder, and anemia.

Conclusions:

  • Current evidence supports the use of novel therapeutic agents for CKD management.
  • Integrated approaches incorporating updated guidelines and newer medications improve patient outcomes.
  • Pharmacists play a crucial role in managing CKD complications and medication therapy.