Chronic/Acute Kidney Disease

Question 1

Loop Diuretic

Ending “…ide” - Frusemide, Bumetanide

Answer 1

MOA
Inhibit reabsopriton of NA and Cl in ascending loop of Henle (potent diuretic)

Indication
Renal impairment
Oedema associated with HF

Side effect
Electrolyte disturbances - hyperkalaemia, low blood sodium, potassium loss, metabolic alkalosis

Counsel
Take in the morning, if 2nd dose is required take at lunch time
Get up gradually as this medication can make you feel dizzy
Monitor reponse, weight and electrolyte

Question 2

Aldosterone Antagonist

Ending in “…one” Spironolactone, Eplerenon, Finerenone

Answer 2

MOA
Inhibit Na absorption in distal convulted tubule by antagonising aldosterone, increasing sodium and water excretion and decreasing potassium excretion

Indication
Chronic HF, Albuminuria (CKD)

Side effect
Hyperkalaemia, acidosis, low blood sodium

Counsel
Dont take potassium supplemts unless advised
Monitor renal function

Question 3

SGLT2 Inhibitor
(Sodium-Glucose Co transporter 2 Inhibitor)

Ending ‘…pagliflozin’ - Dapagliflozin, Empagliflozin

Answer 3

MOA
Inhibit SGLT2, reducing glucose reabsorption in the kidney and there fore increase glucose excretion

Indication
Chronic HF, CKD, T2DM
In CKD it reduces glomerular pressure (hyperfiltration) and tubuloglomerular feedback therefore decreasing progression of CKD

Side effect
Genital infection (thrush), Polyuria, dysuria

Counsel
Drink water to avoid dehydration
Take with or without food