Chronic Kidney Disease Pathway Document Description Presented ...

• Diuretics
• Lithium carbonate
• Mesalazine and other 5-aminosalicylic drugs
• Calcineurin inhibitors (cyclosporin, tacrolimus)
For further information see appendix 3 of the BNF.
http://www.bnf.org/bnf/bnf/current/41003.htm
or contact the Dudley Medicines Management team:
CKD clinical services lead clair.huckerby@dudley.nhs.uk
P.A. for the team Tel. 01384 366589
Patients with CKD should be offered a 6 monthly medication review by a Practice
Based Pharmacist if on 4 or more medicines. This could be more or less frequent
depending on the needs of the individual patient.
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Renal Artery Stenosis
Suspect Atherosclerotic Renal Artery Stenosis (ARAS) in patients whom:
• There is a rise in serum creatinine of > 20% or a fall in eGFR of > 15%
during the first 2 months after initiation of ACE or after any dose increase.
• A rise in serum creatinine of > 20% or a fall in eGFR of > 15% in a 12
month period where there is evidence or suspicion of widespread
atherosclerosis.
• Refractory hypertension – where BP remains >150/90 despite 3
antihypertensives.
• Recurrent episodes of pulmonary oedema despite normal LV function on
echocardiogram (flash pulmonary oedema)
• Unexplained hypokalaemia with hypertension.
These patients should receive referral to nephrology for further investigation and
specialist management.
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