Drug and Therapeutics Bulletin 2006;44:89-95; doi:10.1136/dtb.2006.441289
Copyright © 2006 by the BMJ Publishing Group Ltd.

This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this link to a friend Similar articles in this journal Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Search for Related Content PubMed PubMed Citation

The patient, the drug and the kidney

Relevant BNF section: Appendix 3

Recent policy changes have focused attention on the prevalence of chronic kidney disease (CKD) in the UK.^1–3 In particular, automatic reporting of estimated glomerular filtration rate (e-GFR) is a requirement of the National Service Framework (NSF) for Renal Services in England.¹ Also, the Quality and Outcomes Framework (QOF) of the UK General Medical Services (GMS) Contract (revised in April 2006) requires GPs to keep a renal register of patients with CKD with e-GFRs below 60mL/min/1.73m.^2,4 Prescribers managing such patients are faced with difficult decisions about starting or continuing treatment with drugs that are handled by, or potentially toxic to, the kidney.⁴ Here we review methods of identifying and classifying CKD in adults and the implications of CKD for patients' health. We also offer advice on prescribing for these patients while minimising the risks of drug-related renal toxicity. We do not aim to give detailed guidance on every drug, but rather to highlight general principles of drug therapy and key sources of information and advice.