Renal: Information sources
If you have a renal or critical care pharmacist in your Trust then ask them for advice about managing any patient where you are not sure.For straightforward questions about dose adjustment in renal disease, start with the SmPC and then the Renal Drug Database. Both of these sources tend to give practical advice on dosing according to the extent of impairment.
Now archived but still useful, the website Think Kidneys is a helpful NHS resource with videos, information leaflets, and other resources for patients and professionals. In the Resources section there are a suite of tools and educational materials aimed at pharmacists. A particularly valuable tool is the Medicines Optimisation Toolkit for Acute Kidney Injury (AKI) which helps you choose and review medicines in these patients.
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NICE have published several guidelines on managing patients with kidney disease including CKD, RRT and AKI.
Think about whether there may be expert guidance about the medical condition you have been asked about from a Royal College or other specialist body/hospital. Sometimes their advice will include options for selected groups of patients such as those with renal disease. The TRIP database may help you to track down any expert guidance quickly.
The SPS website has some guidance on managing enquiries about medicines in patients with renal impairment.
For enquiries about drug-induced renal failure, don’t forget all your ADR resources.
Be careful about conducting a general internet search on this subject. If you do, you may like to look at our brief guide to evaluating websites about medicines.