Abstract: SA-PO868
The Role of Renal Pharmacists in the Management of Patients with Renal Conditions
Session Information
- CKD: Socioeconomic Context and Mobile Apps
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Philips, Ragi, Jackson Memorial Hospital, Miami, Florida, United States
- Regis, Catarina, Jackson Memorial Hospital, Miami, Florida, United States
- Venkat, Vasuki N., Miami VA Medical Center/University of Miami/ Jackson Memorial Hospital, Plantation, Florida, United States
- Soberon, Daniel J., Bruce W. Carter VA Medical Center, Hialeah, Florida, United States
- Garcia, Maribel Toro, Miami VA Medical Center, Miami, Georgia, United States
- LadinoAvellaneda, Marco A., Miami VA Medical Center/University of Miami/ Jackson Memorial Hospital, Plantation, Florida, United States
Background
The review of the renal pharmacist role in assisting in the management of CKD is not clear.Our review is the first evaluation in the United States that tests the renal pharmacist as part of the interdisciplinary team in the management of patients with renal conditions.
Methods
This retrospective study assessed the clinical outcomes after the intervention of our renal pharmacist in the Nephrology clinic at the Miami VA Medical Center.The patients were initially evaluated in the outpatient clinic by the nephrologist and the renal pharmacist; medications were changed to decrease the progression of CKD,for the management of hypertension (HTN),immunosuppression and CKD complications.The renal pharmacist followed the patients according to the changes in medical care.
Results
Fifty-six patients were assigned to the renal pharmacist in a 3-month period. Fifty patients (89%) were male; six patients (11%) were female. In 20 patients (35.7%) that had CKD III,HTN,and proteinuria,ACEIs or ARBs were started with close monitoring of the renal function, electrolytes,and proteinuria.In 10 patients (17.9%) that had uncontrolled HTN and CKD, BP medications were added and adjusted.In 9 patients (16.1%) that had a kidney transplant, tacrolimus dosages needed modification to achieve levels.In 15 patients (26.7%) that had CKD IV and V with anemia,erythropoietin stimulating agent dose was adjusted to reach appropriate hemoglobin (HB) levels.In 2 patients (3.6%) that had hypomagnesemia,magnesium supplements and amiloride were added to their medication regimen with close follow up of electrolytes and renal function.The interventions that were made in the 56 patients were successful (Proteinuria decreased, BP was controlled, tacrolimus levels achieved goal, HB levels reached goal),and patient adherence increased
Conclusion
The intervention from renal pharmacists has improved the quality of care in our patients not just by close monitoring of potential adverse effects from therapies, but also by improving BP goals,electrolyte management,and medication adherence.These changes may reduce the progression of CKD,improve cardiovascular outcomes, lower hospital admissions, and decrease the risk of death.