Introduction to Renal Therapeutics

What are the functions of the kidney?

• The functional anatomy of the kidney
• Other functions of the kidneys

Laboratory tests and investigations

• Standard tests and investigations for the general adult patient population
• Haematological tests and investigations
• Urine tests
• Renal biopsy
• Immunological tests
• Serum and urine electrophoresis
• Radiological tests
• Describing and measuring renal function

Acute renal failure

• Definition
• Incidence
• Clinical features
• Causes
• Symptoms/signs
• Distinguishing acute from chronic renal impairment
• Management
• Additional points, Outcome & Conclusion

Chronic renal failure

• Definition
• Clinical features
• Incidence
• Causes
• Symptoms and consequences
• Influence of chronic renal disease on drug handling
• Renal replacement therapies

Renal anaemia

• Maintenance of serum haemoglobin in the healthy individual
• The development and consequences of anaemia of chronic kidney disease
• Assessing the anaemia of chronic kidney disease
• Iron and erythropoiesis-stimulating agents available for the correction of renal anaemia
• Iron preparations
• Initiating iron and erythropoiesis-stimulating agents therapy
• Failure to respond to therapy
• Renal bone disease
• Pathophysiology
• Complications for the skeleton and progression of renal bone disease
• Treatment with phosphate binders
• Treatment with vitamin D
• The role of parathyroidectomy
•  Therapeutic targets
•  New management strategies and new therapeutic agents for renal bone disease

Hypertension and hyperlipidaemia

• Renal replacement therapy
• Haemodialysis
• Continuous renal replacement therapies
• Haemodiafiltration
• Peritoneal dialysis

Renal transplantation

• The donor organ
• Transplant rejection and its prevention
• Transplant immunosuppression
• Post-transplant complications
• The pharmacist’s role in caring for transplant patients

Drug dosing in patients with renal impairment and during renal replacement therapy

• Drug handling considerations in patients with renal impairment
• Assessment of renal function
• Adjusting doses for patients with renal impairment
• Drug handling considerations in patients undergoing renal replacement therapy
• Adjusting drug doses for patients undergoing renal replacement therapy

Drug-induced kidney disease

• Pre-renal (or haemodynamic) acute renal failure
• Intrinsic renal toxicity
• Post-renal damage (obstructive uropathy)

Autoimmune kidney disease

• Pathogenesis
• Clinical manifestations
• Principles of treatment
• Antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis
• Goodpasture’s syndrome
• Systemic lupus erythematosus
• IgA nephropathy
• Membranous glomerulonephritis
• Membranoproliferative glomerulonephritis
• Cryoglobulinaemic glomerulonephritis

Paediatric kidney disease

• Creatinine and glomerular filtration rate
• Monitoring and treatment of children with chronic renal failure
• Transplantation
• Dialysis
• Drug prescribing in renal disease

Renal pharmacy in critical care

• Preventing acute renal failure
• Renal replacement therapy in the intensive care unit
• Drug therapies specific to critical care areas
• General comments on administering drugs to patients with renal impairment

Pain control in renal impairment

• Assessing pain
• The analgesic ladder
• Analgesics and renal impairment
• Individual agents

Diabetes management in kidney disease

• Definitions of diabetic renal disease
• The actual structural changes that occur in the diabetic kidney
• The diagnosis of diabetic renal disease
• The prevention of diabetic renal disease
• The screening and referral process for diabetic renal disease
• The management of diabetes in kidney disease

Myeloma and kidney disease

• Clinical presentation of multiple myeloma
• Investigation and diagnosis of myeloma
• Myeloma kidney
• Treatment options

Palliative care

• Prescribing for symptom control in patients with stage 5 chronic kidney disease managed without dialysis
• Prescribing in the last few days of life
• Dietary management of kidney disease
• Historic pre-dialysis dietary intervention
• Pre-dialysis dietary management
• Dietary management of renal replacement therapy
• Vitamin and minerals
• Malnutrition

Travelling and vaccines

• Planning holidays & General travel health advice
• Travelling abroad with medication
• Malaria
• Travel vaccinations

Case study answers