Overview
Format: One-page Canva slide presentation
Size: 16:9 ratio
Template: Use the same style/design as the attached photo
Design: Simple, professional with few graphics
Content:
Title: Drug–Disease Interactions: Impact of Chronic Kidney Disease (CKD)
Core Principle
- Disease states like CKD alter drug handling and response → changes in PK/PD
Key Comorbidity
- CKD = most critical comorbidity
- Altered clearance → ↑ risk of toxicity or ↓ effectiveness
- Polypharmacy and comorbidities (hypertension, diabetes) amplify drug interaction risks
Prevalence & Impact
- Implicated in 80% of clinically significant drug–disease interactions.
- Associated with ↑ hospitalizations and medication-related morbidity.
Key Examples
| Drug/Class | Potential Problem in CKD |
| NSAIDS | ↓ Renal perfusion → Acute kidney injury |
| Diuretics (Loop) | ↓ effectiveness in advanced CKD; risk of electrolyte imbalance |
| ACE Inhibitors + ARBs | Hyperkalemia, ↓ GFR |
| Antidiabetic Drugs (Metformin, Insulin) | Risk of lactic acidosis (if eGFR <30 mL/min), hypoglycemia due to reduced clearance |
| Antibiotics (e.g. aminoglycosides, vancomycin) | Accumulation → nephrotoxicity & ototoxicity |
| Anticoagulants (e.g., warfarin, DOACs) | Accumulation → ↑ bleeding risk; some require renal dose adjustment or avoidance |
Management Strategies:
- Dose adjustment guided by kidney function (eGFR/CrCl).
- Start low, titrate slowly when initiating therapy.
- Avoid or limit nephrotoxic agents when possible.
- Choose safer alternatives for high-risk drugs.
- Regular monitoring of renal function, electrolytes, and drug levels.
Reference: Shahzadi, A., Sonmez, I., Kose, C., Oktan, B., Alagoz, S., Sonmez, H., Hussain, A., & Akkan, A. G. (2022). The Prevalence of Potential Drug-Drug Interactions in CKD-A Retrospective Observational Study of Cerrahpasa Nephrology Unit. Medicina, 58(2), 183. https://doi.org/10.3390/medicina58020183