Key Terms
Course
Public Health in Pharmacy Practice: A Casebook, 2nd Edition
Chapter
26 - The Hidden Burden of Hemodialysis: Personal and Economic
Impacts Authors
Kelsey Hennig, PharmD, BCPS; Branden D. Nemecek, PharmD, BCPS; Mira Maximos, PharmD, MSc, ACPR, BScPhm, BHSc
CKD
Progressive decline in kidney function; affects 5-15% of US adults.
Highest incidence group
Adults 65 years of age or older.
Primary causes in adults
Diabetes mellitus and hypertension.
Associated risks
Increased rates of mortality and morbidity.
Modality selection is based on
Patient factors, local practice patterns, and clinician-patient discussion. It is a shared decision- making process.
Remaining funding sources
Medicaid and other payers.
ESRD affects
The patient, caregivers, employers, and the healthcare system as a whole.
Evidence base
A systematic review found most clinical pharmacist involvement in CKD was descriptive in nature; all studies reported so
Pharmacists are encouraged to work actively with
Nephrologist, dietician, social worker, nurses, and other team members to resolve patient care challenges.
Presenting complaint
Lethargy, weakness, near-syncope; missed dialysis Friday; left early Wednesday.
Admitting diagnosis
MRSA bacteremia.
Glyburide note
Glyburide is generally avoided in ESRD because it has active metabolites that accumulate and cause prolonged hypoglycemi