Implementation of kidney protective medications in patients with diabetes is challenging. This module highlights the complexities of managing diabetes, including medication access and addressing disparities in care to provide practical guidance for the pharmacist to optimize medication management. This module supplements the previous medication focused modules that more comprehensively review the contemporary management of diabetes.

By the end of this module, learners will be able to:

Patients with chronic kidney disease are often prescribed numerous medications to treat comorbidities, slow the progression of their kidney disease, and to minimize morbidity and mortality. These complex medication regimens  lead to an increased potential for medication therapy problems. This module discusses common medication therapy problems associated with chronic kidney disease, medication reconciliation for this population, and the contributions that pharmacists can provide in medication therapy management.

By the end of this module, learners will be able to:

Hyperkalemia is a significant risk of medications  that slow progression of chronic kidney disease. Oftentimes these medications or their optimal doses are avoided as a means to mitigate the risk of hyperkalemia, withholding the full potential benefit for our patients. Complicating this problem is the reality that evidence-based guidelines for managing hyperkalemia in patients with chronic kidney disease are sparse.

Value-based care has the potential to revolutionize the way pharmacists practice. The success of value-based programs are contingent upon patient outcomes, which are often influenced by the medication therapy problems. Thus, pharmacists are well positioned to be key members of value-based care teams to address complex medication therapy problems in patients with CKD. Value-based kidney care is in its infancy, so it is vital for the pharmacy workforce to be prepared and integrate into these programs.

By the end of this module, learners will be able to:

The cardiovascular benefits of GLP1 RAs have been well characterized in several large cardiovascular outcome trials. The benefits of secondary kidney outcomes in those with diabetes have been observed in these trials. In this module, we will review current evidence supporting the benefits of GLP-1 RAs in the patients with kidney disease. We will also review current clinical guidelines and recommendations for their use and discuss medication and patient-specific efficacy and safety considerations when using them in people with type 2 diabetes and chronic kidney disease.