Prescribing
in
Chronic
Kidney Disease Mary
Vilay,
Pharm
D University
of
New
Mexico College
of
Pharmacy
[email protected]
End
Stage
Renal
Disease
(ESRD)
No.
of
paRents
(in
thousands)
• ESRD
=
dialysis
dependent • Over
500,000
American
have
ESRD
(2007) • Medicare
spent
$23.9
billion
on
ESRD
(2007)
2 USRDS
2009
• Uremia
The
Uremic
Man
– AccumulaRon
of
nitrogenous
waste
products
(urea) –
ConstellaRon
of
symptoms
associated
with
ESRD
3
Deaths per 1000 patient years at risk
All‐cause
Mortality
Rates,
2007
Age (years)
4
USRDS 2009
CKD
DefiniRon NaRonal
Kidney
FoundaRon Kidney
Disease
Outcomes
Quality
IniRaRve (KDOQI) 1. Kidney
damage
(proteinuria/albuminuria)
for ≥3
mo
±
↓ GFR. OR 2. GFR