#69 CKD: Prescribing Do’s and Dont’s with @kidney_boy, Joel Topf

Making all your nephrology dreams come true with part 2 of our interview with  @kidney_boy, Joel Topf, MD Salt Whisperer and Chief of Nephrology at Kashlak Memorial Hospital. Flush away your bad prescribing habits when it comes to nephrotoxic drugs in this fast paced run down of the medications which must stay on or off Santa’s naughty-list, backed up with a sack full of memorable research studies. Special thanks to Annie Medina, Justin Berk and Kate Grant for writing/producing this show and to physician artist, Kate Grant for her lovely/hilarious artwork (more at paintscientific.com).

Full show notes available at http://thecurbsiders.com/podcast

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Time Stamps

• 00:00 Intro
• 03:00 Which medications should we exercise caution over in CKD?
• 03:31 Bactrim (Trimethoprim+Sulfamethoxazole)
• 07:00 NSAIDS
• 08:29 NSAIDS and the ‘Precision’ Trial NEJM 2016 looking at cardiovascular safety
• 12:50 The Male Physician Study JAMA 2001
• 13:50 Discussion about Nurses Health Study and use of analgesia, and CKD
• 15:15 Acute Interstitial Nephritis, Beta Lactam Antibiotics, and the risk of Acute kidney injury +/- CKD with Proton Pump Inhibitors
• 18:20 Advice for co-prescribing NSAIDS,ACE inhibitors and diuretics
• 20:39 Creatinine levels and ACE/ARB prescribing. How High can you go?
• 24:55 Facebook question from listener: measures to reduce proteinuria in hypertensive patients
• 27:20 Empagliflozin and renal protection in diabetic patients
• 32:00 Contrast Induced Nephropathy, the AMACING trial 2016.
• 38:00 Take Home Points
• 39:57 Outro

Tags:  chronic, kidney, disease, nephrology, renal, glomerular, filtration, crcl, gfr, creatinine, medications, pharmacology, bactrim, nsaid