Case scenario

Mrs Patel, a 58-year-old female with poorly controlled type 2 diabetes mellitus (T2DM) and hypertension, visits you requesting a blood pressure check. You learn that she has been experiencing fatigue and leg swelling and has not had recent blood tests. She is taking metformin 850 mg three times daily, perindopril 5 mg each morning, and over-the-counter herbal supplements. You recognise that Mrs Patel has multiple CKD risk factors.

Learning objectives

After reading this article, pharmacists should be able to:

  • Describe the pathophysiology of chronic kidney disease
  • Discuss metabolic disturbances resulting from chronic kidney disease
  • Explain how chronic kidney disease is treated.

Competency standards (2016) addressed: 1.1, 1.4, 1.5, 2.2, 3.1, 3.5

Accreditation number: CAP2511CDMRC

Accreditation expiry: 31/10/2028

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Introduction

Chronic kidney disease (CKD) is a progressive long-term condition characterised by a gradual and usually irreversible decline in kidney function.1 It is defined as a sustained reduction (for 3 months or more) in the measured or estimated glomerular filtration rate (eGFR) to <60 mL/min/1.73 m2 with or without evidence of kidney damage OR evidence of kidney damage (e.g. albuminuria, haematuria) for 3 months or more with or without reduced eGFR.1,2 Due to these changes, CKD is associated with adverse clinical outcomes including end-stage kidney disease (ESKD), cardiovascular disease (CVD), hypertension, stroke and increased mortality.1,2

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