Chronic Kidney Disease (CKD) Review

GFR

Glomerular Filtration Rate: measures how well kidneys remove waste from the blood

Stage 1

GFR (Normal- signs of kidney damage present). Doesn’t usually require a medicine dosage adjustment.

Stage 2

GFR (60-89mL - mild loss of kidney function). Still tolerate standard dosing, but blood pressure and blood glucose should be monitored. *Early detection is important to slow progression.

Stage 3

GFR (30-59mL - moderate kidney impairment). Some renally excreted drugs (ex. antibiotics) may need dosage adjustments. Increased risk for complications like anemia.

Stage Subdivisions:

Stage ?(a): GFR 45-59

Stage? (b): GFR 30-44

Stage 4

GFR (15-29mL-severe kidney impairment; notable symptoms like fatigue, fluid overload, etc.). Need significant dose reductions/extended dosing intervals. Potential additions of specialized meds. Pharmacy software may prompt an intervention/alter about renal impairment.

Stage 5

GFR (<15mL - kidney failure/places on dialysis). Extensive dose adjustments, increased co-morbjd therapies. Dialysis removes some drugs (need post-dialysis dosing schedules).