Kidney Patients With Diabetes: Managing Their Medication
Although accreditation for this CE/CME activity has expired, and the posttest is no longer available, you can still read the full article.
Expires February 28, 2015
–
Because the vast majority of patients with chronic kidney disease (CKD) are diabetic and thus take hypoglycemic medications, knowledge of renal dosing for these medications, their mechanisms of action, and their safety profiles, as well as consideration of A1C goals, is vital for the practicing clinician. Management of the diabetic CKD patient, identified by stage of kidney disease, is outlined, with dosing regimens as determined by the glomerular filtration rate. Special attention is given to insulin management.
PATIENT EDUCATION
There is a correlation between patients who participate in kidney disease education programs and a decrease in the progression of kidney disease (see “Case Study: The Recalcitrant Patient With Diabetes"). These classes can be taught by a physician, physician assistant, nurse practitioner, or clinical nurse specialist. To alleviate the burden of end-stage kidney disease in the US, Medicare Part B pays for six outpatient kidney disease patient education classes per lifetime of the beneficiary.30
Since 2010, when kidney disease education programs were rolled out, over 10,000 classes have been taught.31 Many practitioners report that patients are more compliant and understand their disease better when they attend classes.32 Data are being gathered to determine the effectiveness of the classes on patient outcomes.
On the next page: Conclusion >>
