Renal: Suggested questions

Last updated: Sunday, July 12, 2015

They may not apply to every situation you come across, but here are some questions you should be thinking about in practice if asked to advise on dosage or suitability of a medicine in renal dysfunction:

The Medicine

  • What is the indication for the drug and have alternatives been considered?
  • Which agents would normally be used if the patient did not have renal dysfunction?

The Patient

  • Find out age, weight and height of patient. What is the serum creatinine?
  • Check the degree of renal failure, calculating the creatinine clearance where necessary. Determine if this is acute or chronic. Or is it 'acute on chronic' - someone with pre-existing chronic failure, who has had a sudden drop in function?
  • Is renal function stable, deteriorating or fluctuating?
  • Which, if any, renal replacement therapy is being used? (And ask about the timing of any PD or haemodialysis as necessary.)

Going Forward

  • Who is in a position to change therapy if necessary and who will be monitoring the patient?
  • How might any advice given change if the patient’s renal function deteriorates further? What if it improves?