Chapter 12: The Complications of Chronic Kidney Disease, Second Edition 2 Contact Hours
By: Katie Blair, PharmD, RPh Author Disclosure: Katie Blair, and Colibri Healthcare, LLC do not have any actual or potential conflicts of interest in relation to this lesson. Universal Activity Number UAN: 0607-0000-23-005-H01-P Target Audience: Pharmacists in a community-based setting. To Obtain Credit: A minimum test score of 75 percent is needed to obtain a credit. Please submit your answers either by mail, fax, or online at EliteLearning.com/Book Questions regarding statements of credit and other customer ser- vice issues should be directed to 1-888-666-9053. This lesson is $14.95. Activity Type: Knowledge-based Initial Release Date: 7/10/2023 Expiration Date: 07/10/2026 Learning objectives After completing this course, the learner should be able to: Discuss normal kidney function and the effects of chronic kidney disease on kidney function. Explain the definition of chronic kidney disease and causes of this disease state. Introduction Chronic kidney disease (CKD) is often used as a broad term to describe many levels of decreased kidney function, from mildly decreased renal output to severe kidney failure. This worldwide public health issue affects a significant number of Americans, with a prevalence of approximately 15% in the general population. As many as 9 in 10 U.S. adults do not know that they have chronic kidney disease, and as many as 2 in 5 adults with severe disease are unaware of their condition (Centers for Disease Control and Prevention [CDC], 2021). The leading causes of chronic kidney disease are high blood pressure and diabetes; nearly half of all patients diagnosed with chronic kidney disease have diabetes and/or cardiovascular disease. People with chronic kidney disease are also at a higher risk for developing cardiovascular disease, complicating treatment for CKD patients (National Institute of Di- abetes and Digestive and Kidney Diseases, 2016b).
Colibri Healthcare, LLC is accredited by the Accredita- tion Council for Pharmacy Education (ACPE) as a pro- vider of continuing pharmacy education. Participants of the session who complete the evaluation and provide accurate NABP e-Profile information will have their credit for 2 contact hours (0.2 CEU) submitted to CPE Monitor as early as within 10 business days after course completion and no later than 60 days after the event. Please know that if accurate e-Profile information is not provided within 60 days of the event, credit cannot be claimed after that time. The participant is ac- countable for verifying the accurate posting of CE credit to their CPE Monitor account within 60 days.
Describe the complications associated with chronic kidney disease and their management. Review the medications used to treat common complications of chronic kidney disease.
Chronic kidney disease presents a significant cost burden in the U.S. In 2018, Medicare spending for chronic kidney disease in patients aged 66 years and older exceeded $70 billion, which encompassed over 23.8% of all Medicare spending for this age group. This cost represents a 7.3% increase over the previous year. More than 60% of this spending occurred in CKD patients with comorbidities of diabetes, congestive heart failure, or both (U.S. Renal Data System [USRDS], 2020). With such a high cost to society associated with chronic kidney disease, it is important to ensure patients are treated appropriately in order to slow disease progression and prevent adverse effects. This course serves as a review of chronic kidney disease and the medications used to pre- vent adverse effects of CKD and slow disease progression.
COMPLICATIONS OF CHRONIC KIDNEY DISEASE
Normal kidney function The kidneys are two bean-shaped organs, each of which is ap- proximately the size of a human fist. They are located toward the back side of the abdomen on each side of the spine, just below the rib cage. The primary function of the kidneys is to remove water and waste products from the body. They also produce the essential hormones erythropoietin and renin and convert vitamin D to its active form (DiPiro et al., 2019). Each kidney contains approximately 1 million functioning units, called nephrons , which perform the functions of forming urine and removing unwanted substances from the bloodstream. Each nephron is made up of two major parts: a glomerulus and a tu- bule. The glomerulus filters the blood, removing waste products while keeping large molecules like proteins and blood cells in the bloodstream. The tubule receives and processes the fluid filtered by the glomerulus, saving necessary minerals for return to the bloodstream and removing waste products for removal through the urine (DiPiro et al., 2019).
The kidneys, when functioning normally, regulate the concentra- tion of fluid in the body. They remove excess water if body fluids are too diluted and remove excess salts such as sodium and po- tassium when body fluids are too concentrated. In addition, the kidney plays a role in acid–base balance by excreting hydrogen ions when the blood is too acidic and excreting bicarbonate ions when the blood is too alkaline. Lastly, they remove metabolic by- products such as creatinine, urea, and phosphorus that the body no longer needs (DiPiro et al., 2019). In terms of hormones, the kidneys are responsible for convert- ing vitamin D to its active form, calcitriol, which facilitates calcium absorption in the intestine. The kidneys also manufacture eryth- ropoietin, a hormone that stimulates red blood cell production in the bone marrow. Renin is also produced in the kidneys and plays a significant role in sodium and blood pressure control (DiPiro et al., 2019).
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Book Code: RPTX3024
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