Renal: Learning outcomes

Last updated: Monday, April 18, 2022

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After completing this tutorial, you will be able to:
  • Make decisions about appropriate choice and dose of medicines in patients with renal impairment.
  • Assess and calculate renal function.
  • Describe the main types of renal replacement therapy and how they may affect drug therapy.
  • Explain three mechanisms by which medicines may adversely affect the kidney.

You can download a PDF of the whole tutorial (without interactive elements such as the Learning exercises) and a one-page summary of key points.

You should allow 90 minutes to complete this tutorial, including the Learning exercises.

Competencies

This tutorial is aimed at hospital trainee pharmacists, and will help you achieve GPhC learning outcomes such as these:

  • LO 5 Proactively support people to make safe and effective use of their medicines and devices
  • LO 12 Take an all-inclusive approach to ensure the most appropriate course of action based on clinical, legal and professional considerations
  • LO 16 Apply professional judgement in all circumstances, taking legal and ethical reasoning into account
  • LO 27 Take responsibility for the legal, safe and efficient supply, [prescribing] and administration of medicines
  • LO 29 Apply the principles of clinical therapeutics, pharmacology and genomics to make effective use of medicines for people [including in their prescribing practice]
  • LO 30  Appraise the evidence base and apply clinical reasoning and professional judgement to make safe and logical decisions which minimise risk and optimise outcomes for the person
  • LO 34 Apply the principles of effective monitoring and management to improve health outcomes
  • LO 48 Actively take part in the management of risks and consider the impacts on people.

If you are a foundation pharmacist, this tutorial may assist with meeting certain competencies from the RPS framework including:

  • 1.1 Applies evidence-based clinical knowledge to make suitable recommendations or take appropriate actions 
  • 1.6 Uses own pharmaceutical knowledge to positively impact the usage and stewardship of medicines at an individual and population level.
  • 1.7 Undertakes a holistic clinical review of a person’s medicines to ensure they are appropriate.
  • 2.1 Keeps the individual at the centre of their approach to care at all times.
  • 3.1 Draws upon own knowledge and up-to-date guidance to effectively make decisions appropriately and with confidence.
  • 3.2 Critically appraises appropriate information to make a decision in an efficient and systematic manner; adopts evidence-informed solutions.
  • 3.3 Demonstrate awareness of where to seek appropriate information to solve problems and make decisions. 
  • 3.5 Manages uncertainty and possible risk appropriately, while ensuring high attention to detail is maintained when making decisions regarding the individual receiving care.
  • 6.5 Uses effective questioning when working with individuals receiving care or other healthcare professionals.

Continuing professional development


Finally, here are some CPD activities you could consider:

★  If you make a clinical recommendation about the safety of a medicine in renal disease or advise adjusting a dose because of it, write up what you did as a reflective account. How did you decide what to do? Was your advice accepted? What might have happened to the patient if your advice had not been accepted?
★  Can you plan to visit a renal unit or haemodialysis centre in your area? If so, think about the questions you want to ask before you go and document what you learned.
★  Talk to a more experienced colleague about any interventions you've made involving patients with renal impairment. Were you able to answer the questions posed by your colleague? Were you given any pointers on how to improve?