General Topics

Dear RPN Members,

Unfortunately our email server is not working so we are posting information about the RPN Nephrology Education Day, to be held on March 23 2012 in Toronto, ON, in this discussion forum.

Registration for the event is now open.  For more information, please visit our website at http://www.renalpharmacists.net/civicrm/event/info?reset=1&id=25.

All,

I'm sure we are well aware of the negative preliminary results causing the early stoppage of the ALTITUDE trial (re: aliskiren + ACE/ARB in Type 2 diabetic patients). My question for those who work the various hypertension / outpatient clinics, what has been the response that the doctors in your practice doing in light of this data?

what formula do you use in your practice???

Hi, At our centre in Halifax we have noticed approximately 5 patients who reacted unfavorably to iron dextran (InFuFer Brand) ( Bronchspasm, hypotension, tachcardia etc) from the test dose of iron dextran in the past 2 months. I have contacted the company to see if there has been any formulaton changes but is anyone else seeing a disproportionately high number of reactions to iron dextran in their renal program?
Thanks
Jo-Anne

This question is way out there....

Does anyone have any experience in longterm use of sodium thiosulfate? We have a patient currently receiving 25grams IV 4 times weekly in hemodialysis and has now received 7 months of this drug.

Clinically, she is doing much better than before.

Hi, Does anyone have a protocol or has used a fixed dose of UFH 250 IU/kg Sc BID as an alternative to IV UFH for bridging hemodialysis patients who are on warfarin requiring interventional procedures.

Jo-Anne
Halifax

A colleague of mine in Guelph has recently starting accepting PD inpatients, they have kayexalate on one of their routine orders. One of their gi docs is concerned about kayexalate powder causing too much constipation (and wants to use the sorbitol containing formulation), I on the other hand seem to see more diarrhea if anything with the powder. Just need to know who dispenses the powder (unless sorbitol formulation is specifically requested) and if there have been any problems with contipation being an issue?

Hi,

Hello everyone.

I am wondering if any pre-dialysis CKD clinics are using Ferrlecit for this patient population.

If so, I am wondering about infusion times. According to the product monograph Ferrlecit can be administered at a rate of 12.5 mg/min undiluted in hemodialysis. Is anyone doing this for pre-dialysis patients? Are you seeing higher incidents of adverse reactions in doing so?

Any insight would be terrific.

Thanks,

Evelena

All,

Background: We have a patient in our hemodialysis unit a mantle cell lymphoma.  The patient refuses to seek an oncologist opinion on treating this cancer, despite our repeated attempts to help the patient.  Being on hemodialysis, he is anemic.  Prior to the lymphoma, we successfully treated the anemia of CKD with EPO (ie Hgb between 110-120g/L).  Since we learned of the diagnosis 2 months ago, we have held the EPO.  His last hemoglobin is at 91.