The RCGP have produced an AKI Toolkit to disseminate learning from AKI cases. Medicines Learning Portal

Full access to over 800 drug monographs that comprise concise information on clinical use, dosing, important drug interactions, metabolism and drug administration.contains pharmacokinetic data to inform how the medicine will be removed, e.g. amount of parent medicine excreted through the kidneys, how any active metabolites are removed, impact of kidney disease on medication half-life The BNF is rarely used as a sole information source for managing medicines in renal impairment. Renal Drug Handbook and Renal Drug Database Caroline Ashley is the Lead Specialist Pharmacist for Renal Services at the University College London Centre for Nephrology and Transplantation at the Royal Free Hospital. She has over 25 years' experience, with major interests in transplantation and auto-immune renal disease. Caroline was involved in the development of the Renal National Service Framework, and the NICE Guidelines on Immunosuppression in Renal Transplantation, Renal Anaemia and Acute Kidney Injury. She is the co-editor of The Renal Drug Handbook, The Renal Drug Database and The Introduction to Renal Therapeutics and sits on the editorial board of the British Journal of Renal Medicine. She was Chair of the Uk Renal Pharmacy Group from 1996 to 2016, and was made Associate Professor of Pharmacy Practice, UCL School of Pharmacy in 2011. The Renal Drug Database (subscription required) is available online and as a handbook. Both contain: For many drugs, some or even all of the altered pharmacokinetic parameters and modified interrelationships are unknown. In such circumstances, the informed professional judgement of clinicians and pharmacists must be used to predict drug disposition. This must be based on knowledge of the drug, its class, chemistry and pharmacokinetics in patients with normal renal function.

One limitation is that the handbook is a UK publication so some of the drugs and dosing recommendations are not relevant to the Australian situation. Perhaps a consideration for future editions might be to include some general comments on the use of various drug classes in patients with renal disease. The information contained within The Renal Drug Database is validated and governed by the UK Renal Pharmacy Group (UKRPG). For further information in the UKRPG, including its aims, events and activities, please visit: www.renalpharmacy.org.ukprovide a practice-based review of drug utilisation in renal units across the UK indicating, where appropriate, any local methods of use, licensed or otherwise. Physical Examination Procedures for Advanced Practitioners and Non-Medical Prescribers - 2nd ed. (2015) provide healthcare professionals with a single reference of easily retrievable, practical information relating to drug use, sourced from the practical experience of renal units throughout the UK. By referring to the monographs, the user is guided in how to prescribe, prepare and administer the drug with due regard to potentially serious drug interactions and to any renal replacement therapy the patient may be undergoing.

CRC Press publishes medical books across a wide range of therapy areas including Toxicology, Pharmaceutical Science, Infectious Disease, Oncology, Nephrology, Gastroenterology and Hepatology. CRC Press authors and editors are among the leaders in medical science, and many of our publications document the notable contributions they have made to their own specialist fields. You can find details about all our books by visiting https://www.crcpress.com/medicine Launched in 2014, The Renal Drug Database comprises all monograph information from the highly successful The Renal Drug Handbook, the universally-trusted resource for pharmacists seeking definitive prescribing information when treating patients with renal impairment. Pharmaceutical Preformulation and Formulation: a Practical Guide from Candidate Drug Selection to Commercial Dosage Form - 2nd ed. (2009) A universally-trusted resource, this edition of The Renal Drug Handbook contains over 800 drug monographs comprising prescribing information for clinical and medicines information pharmacists. Many of these problems can be avoided by careful choice and use of drugs. The Renal Drug Database seeks to assist healthcare professionals in this process.

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This is a much-needed reference with good and precise explanations of relevant drugs. One of the noteworthy aspects is that the authors have tried their best to translate the important information into a concise but effective format. The authors must be applauded for maintaining the uniform presentation structure for each drug monograph. Overall, this is an excellent handbook for anybody who wants to learn about drugs at a glance or wishes a quality reference for prescribing for those with renal impairment. Altered pharmacokinetics of some drugs, i.e. changes in absorption, tissue distribution, extent of plasma protein binding, metabolism and excretion. In renal impairment these parameters are often variable and interrelated in a complex manner. This may be further complicated if the patient is undergoing renal replacement therapy. Renal function generally declines with age, and many elderly patients have a GFR less than 50 mL/min which, because of reduced muscle mass, may not be reflected by an elevated creatinine. Consequently, one can justifiably assume mild renal impairment when prescribing for the elderly.

the kidney function expressed as estimated glomerular filtration rate (eGFR) normalised to a body surface area of 1.73m 2 individual medicine monographs on how to prescribe, prepare and administer the medicine in various types of renal impairment Pharmaceutical Excipients: Properties, Functionality and Applications in Research and Industry (2017) The manufacturers information should always be followed unless a renal specialist advises otherwise. Prescribing or administering a medication outside the manufacturers information may render the medicine being used off-label. Summary of Product Characteristics (SmPC)

In addition to our own resources, we recommend the following resources for information about specific medicines in renal impairment. This handbook provides detailed drug information to assist healthcare professionals to safely dose medications in patients with kidney disease. It is also available online which I suspect will extend the readership from predominantly renal pharmacists to other groups. The use of drugs in patients with impaired renal function can give rise to problems for several reasons: