Ckd medications
Searched over 200M research papers for "ckd medications"
Summary
10 papers analyzed
Some studies suggest that certain medications like renin-angiotensin system inhibitors and SGLT2 inhibitors can benefit CKD patients, while other studies highlight the risks and uncertainties associated with various treatments, including febuxostat, vitamin D therapy, and psychotropic agents.
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Chronic Kidney Disease (CKD) Medications: A Comprehensive Overview
Medication Therapy Management in CKD
Medication Therapy Management (MTM) Post-Hospitalization
A study aimed to reduce acute care utilization through a pharmacist-led MTM intervention for CKD patients post-hospitalization. Despite the comprehensive approach, including medication reviews and action plans, the intervention did not significantly reduce hospital readmissions or emergency visits compared to usual care.
Cognitive Impairment and CKD Medications
Drugs Impacting Cognitive Functions
CKD patients often have complex medication regimens due to multiple comorbidities. Certain medications, such as psychotropic agents, anticholinergics, GABAergic drugs, opioids, and corticosteroids, have been linked to cognitive impairment. These drugs are frequently prescribed to CKD patients, necessitating careful consideration to avoid exacerbating cognitive decline.
Urate-Lowering Therapy
Febuxostat for Hyperuricemia in CKD
A randomized trial investigated febuxostat in stage 3 CKD patients with asymptomatic hyperuricemia. The study found no significant difference in kidney function decline between febuxostat and placebo groups. However, febuxostat significantly reduced the incidence of gouty arthritis without notable adverse events.
Cardiovascular Medications in CKD
Pharmacotherapy for Acute Coronary Syndrome (ACS) in CKD
CKD patients presenting with ACS have worse outcomes and are less likely to receive evidence-based therapies. The American Heart Association highlights the need for tailored pharmacotherapy in this high-risk group, emphasizing the underrepresentation of CKD patients in clinical trials and the necessity for more inclusive research.
Cardioprotective Medication Use
A study on medication patterns in CKD patients revealed underutilization of cardioprotective drugs. Despite the high prevalence of cardiovascular complications, medications like statins, ACE inhibitors, and ARBs were not consistently prescribed, indicating a gap in optimal care practices.
Renin-Angiotensin System (RAS) Inhibitors
RAS Inhibitors in CKD Management
RAS inhibitors, including ACE inhibitors and ARBs, are effective in reducing proteinuria and slowing CKD progression. These medications are particularly beneficial in diabetic patients, delaying the onset of microalbuminuria and reducing cardiovascular mortality. However, a multimodal approach, including lifestyle modifications, is often necessary for comprehensive management.
Vitamin D Therapy
Effectiveness of Vitamin D in CKD
A systematic review and meta-analysis evaluated vitamin D therapy in CKD patients. The findings suggest that vitamin D does not significantly reduce all-cause mortality, fractures, or cardiovascular deaths. However, it effectively lowers serum parathyroid hormone and alkaline phosphatase levels, albeit with an increased risk of hypercalcemia.
SGLT2 Inhibitors
SGLT2 Inhibitors for CKD and Cardiovascular Disease
SGLT2 inhibitors, initially developed for diabetes management, have shown benefits in reducing CKD progression and cardiovascular events. The CREDENCE trial confirmed these benefits in CKD patients with type 2 diabetes, highlighting the importance of these inhibitors in reducing risks for both kidney and cardiovascular diseases.
Emerging Therapies
Tamoxifen as an Antifibrotic Agent
Research indicates that tamoxifen, traditionally used for breast cancer, may have antifibrotic effects in CKD. In experimental models, tamoxifen combined with losartan and mycophenolate mofetil showed enhanced renoprotection, reducing hypertension, albuminuria, and renal fibrosis. This suggests potential for tamoxifen as an adjunct therapy in CKD management.
Medication-Related Problems (MRPs)
Prevalence and Management of MRPs
CKD patients are at high risk for MRPs due to complex medication regimens. These problems are associated with increased morbidity, mortality, and reduced quality of life. Effective strategies to manage MRPs include regular medication reviews and patient education to optimize therapeutic outcomes.
Conclusion
Managing CKD involves a multifaceted approach, including careful selection and monitoring of medications to address comorbidities and slow disease progression. While traditional therapies like RAS inhibitors and emerging treatments like SGLT2 inhibitors show promise, the complexity of CKD pharmacotherapy necessitates ongoing research and tailored patient care strategies.
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