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
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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.
CONCLUSION
Knowing how to manage the patient with both diabetes and kidney disease is increasingly vital as this patient population grows. Much of the management of these patients will fall to the primary care practitioner.6 The most effective way to start treatment is to identify which CKD stage the patient fits into.
Once the patient is properly categorized, safe and effective diabetic medications can be selected and dosed according to stage. Although the new classification system may be difficult to incorporate into some electronic medical record systems and practitioner behavior, ultimately, it will allow safer management of the patient with CKD and a better predictive power of outcome.
