The kidneys are amazing organs. These compact ‘bean’ shaped filters weigh around 150 g and process about 25% of total cardiac output or 1,200 mL of blood/minute.1

Learning objectives

After reading this article, pharmacists should be able to:

  • Describe the principles of management for a patient with reduced renal function.
  • Discuss treatment strategies for slowing progression of chronic kidney disease, including dosing and monitoring plans in diabetes and hypertension.
  • Discuss the role of the pharmacist in terms of strategies and considerations for medication management in kidney disease.

Competency standards addressed (2016): 1.1, 1.5, 3.1, 3.2.

Kidneys play a vital role in regulation of water and electrolyte content by filtration, secretion and reabsorption.1 They also produce renin, which is important for water and electrolyte balance.1 Kidneys maintain the acid/base balance in the body, and are responsible for excretion of waste products, water soluble toxic substances and drugs, through urine production. Additionally, kidneys regulate a number of endocrine functions such as activation of erythropoietin and vitamin D.

Kidney disease is abnormal kidney structure or function which impacts an individual’s health.2 It can lead to multiple complications such as hypertension, restless legs, renal bone disease and anaemia. Pharmacists have a role in the management of all stages of kidney disease by assisting patients with medication adherence, identifying medication-related issues, and preventing use of nephrotoxic drugs.3

This article includes causes of kidney disease, the different types of chronic kidney disease (CKD) (particularly stages three and four), strategies to slow progression, and adjustment of medicines.

Test your knowledge on this article’s assessment questions here to earn up to 1.5 Group 2 CPD credits.