If a patient is on dialysis it is not recommended to try to calculate the patient’s renal function, by definition they have end-stage renal disease (chronic kidney disease stage 5) so have no renal function.

It is important not to assume a transplant patient has normal renal function – a few do but most don’t. Bear in mind they have only one functioning kidney which receives constant levels of potentially nephrotoxic medicine (tacrolimus). Their renal function should be calculated as usual, using either Cockcroft and Gault, CKD-EPI or the MDRD equation, and then amend medicine doses accordingly.

Practice points

• Consider your current practice. What do you do to support patients taking medication with renal impairment? How could you help to improve their awareness of high-risk medicines?
• Think about what is unique to pharmacy that you can provide to patients differently to a GP. Does your pharmacy do community outreach programmes? Are there any ways to raise awareness in the community?

Once you've completed this module, move onto:
Part three: Chronic kidney disease
But be sure to click next to complete this module first.