Case scenario

Mrs Johnson, 72, visits your pharmacy seeking over-the-counter relief for her lower back pain. She shares that her GP has advised her to avoid certain analgesics due to her reduced kidney function, though she could not recall the specifics. You review her My Health Record, and assess her medical history. Mrs Johnson weighs 56 kg and has a blood pressure reading of 137/90 mmHg from your measurement in the pharmacy. Her recent My Health Record shows an eGFR of 52 mL/min/1.73 m2 and serum creatinine of 95 micromoL/L. Her current medications include apixaban (5 mg twice daily), fenofibrate (145 mg daily), sotalol (80 mg twice daily), metformin (1 g twice daily), rosuvastatin (5 mg daily), valproate (200 mg twice daily), thiamine (100 mg daily), candesartan (8 mg daily) and insulin glargine (18 units at bedtime).

Learning objectives

After reading this article, pharmacists should be able to:

  • Discuss the methods used to estimate renal function to guide adjustment of doses in chronic kidney disease
  • List commonly prescribed medicines that may require dose reduction or cessation in people with chronic kidney disease
  • Discuss risk factors for developing chronic kidney disease
  • Describe strategies to optimise quality use of medicines in patients with chronic kidney disease.

Competency (2016) Standards addressed: 1.1, 1.4, 1.5, 2.2, 3.1, 3.2, 3.3, 3.5

Accreditation number: CAP2405CDMRC

Accreditation expiry: 30/04/2027

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