Chronic kidney disease (CKD) is a major health concern with a growing disease burden and inequalities in access to treatments. Glomerular filtration rate (GFR) is accepted as the best overall measure of kidney function and is considered the most important measure for medications cleared by the kidneys. In clinical practice, equations that estimate GFR using validated prediction equations are routinely used. This practice update was developed by a Working Group comprising clinical pharmacists representing the Society of Hospital Pharmacists of Australia (SHPA) Specialty Practice streams of Nephrology, Oncology and haematology, Critical care and Infectious diseases. It is intended to provide practical recommendations for clinical pharmacists who use equations to estimate GFR for medication dosing decisions. The limitations of the various equations in use — such as the Chronic Kidney Disease Epidemiology Collaboration (CKD‐EPI), the Cockcroft–Gault equation and Modification of Diet in Renal Disease — are summarised and compared to direct measures of kidney function using exogenous markers. The CKD‐EPI equation is recommended to be used routinely as a primary measure of kidney function. Dose adjustments should also consider medication‐specific, patient‐related, and disease‐related characteristics. Kidney function and the response to therapy should be continuously assessed by monitoring the signs, symptoms and disease outcomes, the emergence of adverse reactions or medication‐induced disorders and use therapeutic drug monitoring (if available) to adjust doses accordingly.

Journal of Pharmacy Practice and ResearchVolume 50, Issue 3 p. 263-275 Practice Standards Standard of practice in nephrology for pharmacy services Carla Scuderi BPharm, MClinPharm, MSHP, Corresponding Author Carla Scuderi BPharm, MClinPharm, MSHP specialtypractice@shpa.org.au orcid.org/0000-0002-3651-8325 Nephrology Leadership Committee, The Society of Hospital Pharmacists of Australia, Collingwood, Australia Royal Brisbane and Women’s Hospital, Herston, Australia School of Pharmacy, University of Queensland, Woolloongabba, Australia Address for correspondence: Carla Scuderi, Nephrology Leadership Committee, The Society of Hospital Pharmacists of Australia, 3/65 Oxford St, Collingwood, Victoria 3066, Australia. E-mail: specialtypractice@shpa.org.auSearch for more papers by this authorMichelle Nalder BPharm(Hons), MClinPharm, MSHP, Michelle Nalder BPharm(Hons), MClinPharm, MSHP Nephrology Leadership Committee, The Society of Hospital Pharmacists of Australia, Collingwood, Australia The Royal Melbourne Hospital, Parkville, AustraliaSearch for more papers by this authorRonald Castelino BPharm, MPharm, PhD, BCGP, MSHP, Ronald Castelino BPharm, MPharm, PhD, BCGP, MSHP Nephrology Leadership Committee, The Society of Hospital Pharmacists of Australia, Collingwood, Australia Faculty of Health and Medicine, University of Sydney, Sydney, Australia Blacktown Hospital, Western Sydney Local Health District, Blacktown, AustraliaSearch for more papers by this authorMatthew Cervelli BPharm, MSHP, Matthew Cervelli BPharm, MSHP Nephrology Leadership Committee, The Society of Hospital Pharmacists of Australia, Collingwood, Australia Renal Unit, Royal Adelaide Hospital, Adelaide, Australia MJC Pharma Pty Ltd, Adelaide, AustraliaSearch for more papers by this authorDanielle Ironside BPharm(Hons), GradCertClinPharm, MSHP, Danielle Ironside BPharm(Hons), GradCertClinPharm, MSHP Nephrology Leadership Committee, The Society of Hospital Pharmacists of Australia, Collingwood, Australia Royal Brisbane and Women’s Hospital, Herston, AustraliaSearch for more papers by this authorCeridwen Jones BPharm, DHospPharm, Ceridwen Jones BPharm, DHospPharm Nephrology Leadership Committee, The Society of Hospital Pharmacists of Australia, Collingwood, Australia Royal Prince Alfred Hospital, Camperdown, AustraliaSearch for more papers by this authorJess Lloyd BPharm, GDClinPharm, MSHP, Jess Lloyd BPharm, GDClinPharm, MSHP The Princess Alexandra Hospital, Brisbane, AustraliaSearch for more papers by this authorSanja Mirkov BPharm, PGDipPH, MSHP, Sanja Mirkov BPharm, PGDipPH, MSHP Nephrology Leadership Committee, The Society of Hospital Pharmacists of Australia, Collingwood, Australia School of Pharmacy, The University of Auckland, Auckland, New Zealand Ramsay Pharmacy Group, Sydney, AustraliaSearch for more papers by this authorCourtney Munro BPharm, GradCertPharmPrac, MPharmPrac, MSHP, AACPA, PhD, Courtney Munro BPharm, GradCertPharmPrac, MPharmPrac, MSHP, AACPA, PhD orcid.org/0000-0001-6941-7670 The Society of Hospital Pharmacists of Australia, Collingwood, AustraliaSearch for more papers by this author Carla Scuderi BPharm, MClinPharm, MSHP, Corresponding Author Carla Scuderi BPharm, MClinPharm, MSHP specialtypractice@shpa.org.au orcid.org/0000-0002-3651-8325 Nephrology Leadership Committee, The Society of Hospital Pharmacists of Australia, Collingwood, Australia Royal Brisbane and Women’s Hospital, Herston, Australia School of Pharmacy, University of Queensland, Woolloongabba, Australia Address for correspondence: Carla Scuderi, Nephrology Leadership Committee, The Society of Hospital Pharmacists of Australia, 3/65 Oxford St, Collingwood, Victoria 3066, Australia. E-mail: specialtypractice@shpa.org.auSearch for more papers by this authorMichelle Nalder BPharm(Hons), MClinPharm, MSHP, Michelle Nalder BPharm(Hons), MClinPharm, MSHP Nephrology Leadership Committee, The Society of Hospital Pharmacists of Australia, Collingwood, Australia The Royal Melbourne Hospital, Parkville, AustraliaSearch for more papers by this authorRonald Castelino BPharm, MPharm, PhD, BCGP, MSHP, Ronald Castelino BPharm, MPharm, PhD, BCGP, MSHP Nephrology Leadership Committee, The Society of Hospital Pharmacists of Australia, Collingwood, Australia Faculty of Health and Medicine, University of Sydney, Sydney, Australia Blacktown Hospital, Western Sydney Local Health District, Blacktown, AustraliaSearch for more papers by this authorMatthew Cervelli BPharm, MSHP, Matthew Cervelli BPharm, MSHP Nephrology Leadership Committee, The Society of Hospital Pharmacists of Australia, Collingwood, Australia Renal Unit, Royal Adelaide Hospital, Adelaide, Australia MJC Pharma Pty Ltd, Adelaide, AustraliaSearch for more papers by this authorDanielle Ironside BPharm(Hons), GradCertClinPharm, MSHP, Danielle Ironside BPharm(Hons), GradCertClinPharm, MSHP Nephrology Leadership Committee, The Society of Hospital Pharmacists of Australia, Collingwood, Australia Royal Brisbane and Women’s Hospital, Herston, AustraliaSearch for more papers by this authorCeridwen Jones BPharm, DHospPharm, Ceridwen Jones BPharm, DHospPharm Nephrology Leadership Committee, The Society of Hospital Pharmacists of Australia, Collingwood, Australia Royal Prince Alfred Hospital, Camperdown, AustraliaSearch for more papers by this authorJess Lloyd BPharm, GDClinPharm, MSHP, Jess Lloyd BPharm, GDClinPharm, MSHP The Princess Alexandra Hospital, Brisbane, AustraliaSearch for more papers by this authorSanja Mirkov BPharm, PGDipPH, MSHP, Sanja Mirkov BPharm, PGDipPH, MSHP Nephrology Leadership Committee, The Society of Hospital Pharmacists of Australia, Collingwood, Australia School of Pharmacy, The University of Auckland, Auckland, New Zealand Ramsay Pharmacy Group, Sydney, AustraliaSearch for more papers by this authorCourtney Munro BPharm, GradCertPharmPrac, MPharmPrac, MSHP, AACPA, PhD, Courtney Munro BPharm, GradCertPharmPrac, MPharmPrac, MSHP, AACPA, PhD orcid.org/0000-0001-6941-7670 The Society of Hospital Pharmacists of Australia, Collingwood, AustraliaSearch for more papers by this author First published: 11 June 2020 https://doi.org/10.1002/jppr.1649Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Volume50, Issue3June 2020Pages 263-275 RelatedInformation