Chronic kidney disease

Chronic kidney disease (CKD) is a prevalent and severe condition that progresses silently in most patients.¹ As such, many patients are not diagnosed until the late stages of CKD, resulting in a greater risk of poor outcomes, such as end-stage renal disease requiring dialysis or transplant.¹ Even more alarming is that the risk of death due to cardiovascular causes increases significantly as CKD progresses.²

The most common conditions that prematurely place patients at risk of CKD are diabetes (leading cause of kidney disease), hypertension and cardiovascular disease (CVD is also the most common cause of death in patients on dialysis).^1–3 In fact, patients with CKD are more likely to die from heart disease before they reach end-stage renal disease.^1,4
To reduce the rate of disease progression and effectively manage CV risk, patients need to be identified and interventions initiated as early as possible.

Chronic disease management and monitoring in pharmacy have become routine for patients with hypertension and diabetes in many countries. In line with this trend, the pharmacy team is ideally placed to support CKD screening through at-risk patient identification, counselling and referral, having a significant impact on CKD patients’ future outcomes and quality of life.

^{1. World Kidney Day. Chronic kidney disease. Available at: https://www.worldkidneyday.org/facts/chronic-kidney-disease (Accessed July 2022).

2. Wright J, Hutchison A. Vasc Health Risk Manag 2009; 5:713–722.

3. Tong J, et al . Kidney Blood Press Res 2016; 41:479–487.

4. National Kidney Foundation. National Kidney Foundation. CKD patients more likely to die from heart disease than to develop kidney failure. 2008. Available at: https://www.kidney.org/news/newsroom/nr/77 (Accessed May 2022).}

Publications

Infographic

The infographic is a one-page digital visual aid that serves as a quick reference guide on where, when and why to use the CKD Pharmacy Toolkit in pharmacy practice (with quick links to the toolkit’s practice resources). The infographic is to be used on social media and in print to support the launch of the CKD Pharmacy Toolkit.

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CKD Pharmacy Toolkit Guide

The CKD Pharmacy Toolkit Guide serves as a reference for pharmacists and pharmacy team members (where appropriate) using the toolkit. The purpose of the Toolkit Guide is to identify and describe each practice resource included in the Toolkit. The contents will provide support during the implementation of this programme which has been carefully designed for pharmacists by pharmacists.

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eLearning Modules

The eLearning modules (Understanding Chronic Kidney Disease and Identifying patients at risk of CKD) provide foundational knowledge about CKD for pharmacists and pharmacy team members (where appropriate) to support at-risk patient identification and counselling. Both modules can be completed by all pharmacy staff.

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Disease Awareness Posters

The disease awareness posters include key, high-level information about what CKD is, how it can be symptomless and that simple tests exist to screen for it. They are aimed at anyone who visits the pharmacy, to prompt them to initiate a conversation with a pharmacist about their CKD risk.

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CKD Risk Assessment Tool

The CKD Risk Assessment Tool has been developed to be used by pharmacists to support counselling patients on the risk of CKD, the condition itself and how they can be screened for it. It is set out as a flow diagram of a standardised conversation with a patient, including question prompts and education reminders as well as an abridged list of risk factors which can be used as a criterion for CKD screening.

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Patient Information Leaflet

The Patient Information Leaflet is to be used to summarise the interaction with the patient and to provide supplemental information. The handout has been developed to be shared by a pharmacist with patients at risk of CKD to serve as a prompt to encourage the patient to get screened for CKD and to take the ISN “Are your kidneys healthy?” self-assessment quiz.

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Primary Care Referral Letter

The Primary Care Referral Letter provides a summary of why the patient has been identified as at risk of CKD and why they may benefit from kidney function testing for early detection. The referral letter is to be sent by pharmacists to the primary care physician of the patient at risk of CKD.

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Events/Webinars

The role of pharmacists in chronic kidney disease

June 13, 2023

Chronic kidney disease (CKD) is a prevalent and severe condition that progresses silently in most patients. As such, many patients are not diagnosed until the late stages of CKD, resulting in a greater risk of poor outcomes, such as end-stage renal disease requiring dialysis or transplant. Community pharmacists and their teams are ideally placed to raise CKD awareness, identify those at risk and be the driving force behind earlier detection and referral to primary care partners for screening, diagnosis and intervention. At this event, the “Chronic kidney disease – Toolkit Guide” to support pharmacists in providing a range of CKD pharmacy services will be presented.

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