{"id":635723,"date":"2026-03-26T09:30:56","date_gmt":"2026-03-26T13:30:56","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=635723"},"modified":"2026-03-25T12:43:21","modified_gmt":"2026-03-25T16:43:21","slug":"pharmacist-role-in-kidney-health","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/pharmacist-role-in-kidney-health\/","title":{"rendered":"The pharmacist\u2019s role in kidney health"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Kidney disease is a progressive condition that many patients live with, sometimes without even knowing they have it. As vital organs, the kidneys are key points for monitoring dosages, drug interactions, and potential nephrotoxic effects.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Pharmacists can be valuable in advising patients on kidney health, especially by adjusting medications and flagging harmful drug interactions. Picking up prescriptions at the pharmacy may be one of the few times that patients get the nudge they need to get their kidney health checked.\u00a0<\/span><\/p>\n<h2 id=\"the-prevalence-of-kidney-disease-in-the-u-s\"><span style=\"font-weight: 400;\">The prevalence of kidney disease in the U.S.<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Chronic kidney disease (CKD) is one of the most common conditions in the U.S., affecting <\/span><a href=\"https:\/\/www.niddk.nih.gov\/health-information\/health-statistics\/kidney-disease\"><span style=\"font-weight: 400;\">almost 36 million<\/span><\/a><span style=\"font-weight: 400;\"> Americans. It\u2019s often associated with other chronic conditions, such as diabetes and high blood pressure, which can make the risk even more severe.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">What\u2019s more, <\/span><a href=\"https:\/\/www.cdc.gov\/kidney-disease\/php\/data-research\/index.html\"><span style=\"font-weight: 400;\">almost 90% of patients<\/span><\/a><span style=\"font-weight: 400;\"> with CKD don\u2019t even know they have it. That\u2019s because many patients don\u2019t experience any significant symptoms in the early stages. As a patient\u2019s estimated glomerular filtration rate (eGFR) worsens, more severe symptoms may appear, especially after kidney damage has already become apparent.\u00a0<\/span><\/p>\n<h2 id=\"medication-management-in-kidney-disease\"><span style=\"font-weight: 400;\">Medication management in kidney disease<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Most, if not all, prescription medication labels discuss whether active drug ingredients are metabolized by the kidneys. After all, the kidneys are responsible for filtering and clearing many medications from the body. Reduced kidney function could mean drug accumulation and toxicity, which could lead to severe side effects.<\/span><\/p>\n<h3 id=\"dosage-adjustments-based-on-kidney-function\"><span style=\"font-weight: 400;\">Dosage adjustments based on kidney function<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Pharmacists are in a position to monitor correct dosages based on kidney function, especially in <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/pharmacist-role-in-senior-care\/\"><span style=\"font-weight: 400;\">older adults<\/span><\/a><span style=\"font-weight: 400;\"> or those with CKD. Some medications require lower doses and longer dosing intervals, or they should be avoided altogether if eGFR is below a certain threshold.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Medications that need special attention include the following:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Metformin:<\/b><span style=\"font-weight: 400;\"> This common Type 2 diabetes drug is mainly cleared through the kidneys. It should be used with caution when eGFR falls below 45 mL\/min\/1.73 m\u00b2 and is contraindicated <\/span><a href=\"https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2018\/020357s034,021202s018lbl.pdf\"><span style=\"font-weight: 400;\">below 30<\/span><\/a><span style=\"font-weight: 400;\"> mL\/min\/1.73 m\u00b2 due to the risk of lactic acidosis.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>NSAIDs: <\/b><span style=\"font-weight: 400;\">Nonsteroidal anti-inflammatory drugs like ibuprofen and naproxen may affect blood flow to the kidneys and worsen renal function, especially at high or prolonged doses. They should generally be avoided in CKD due to the risk of acute kidney injury (AKI).\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Certain antibiotics: <\/b><span style=\"font-weight: 400;\">Aminoglycosides like gentamicin and tobramycin can worsen kidney damage or cause kidney injury. These antibiotics can cause direct nephrotoxicity, warranting their avoidance altogether. Antibiotics such as fluoroquinolones may be prescribed with caution and at lower doses in patients with CKD.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>DOACs: <\/b><span style=\"font-weight: 400;\">Direct oral anticoagulants like rivaroxaban, dabigatran, and apixaban are all excreted through the kidneys to some extent. Therefore, they often need to be monitored and adjusted based on kidney function. Dabigatran has the <\/span><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC7093256\/\"><span style=\"font-weight: 400;\">highest renal clearance<\/span><\/a><span style=\"font-weight: 400;\"> among this drug class.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Since kidney function can vary with a patient\u2019s age and overall condition, pharmacists and healthcare providers need to be vigilant for potential renal effects. Otherwise, patients could expect worsened adverse effects.<\/span><\/p>\n<h2 id=\"beware-of-the-triple-whammy\"><span style=\"font-weight: 400;\">Beware of the \u201ctriple whammy\u201d<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">For many patients taking several medications, it\u2019s especially important to watch for the triple whammy, a classic <\/span><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC12569550\/\"><span style=\"font-weight: 400;\">dangerous drug combo<\/span><\/a><span style=\"font-weight: 400;\"> that can harm the kidneys. Consisting of an ACE inhibitor or ARB, a diuretic, and an NSAID, this combination can decrease kidney perfusion and increase the risk of an AKI.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Patients on an ACE inhibitor or ARB and a diuretic might stop by the pharmacy to pick up an NSAID as an everyday pain reliever without knowing the potential risk. Or, they might be on a regular NSAID for arthritis and receive a new prescription for an ACE inhibitor-diuretic combo. Seeing this combination could be a cue for a pharmacist to intervene, especially given the higher risk at the <\/span><a href=\"https:\/\/www.bmj.com\/content\/346\/bmj.e8525\"><span style=\"font-weight: 400;\">start of treatment<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<h2 id=\"early-detection-and-screening-in-pharmacies\"><span style=\"font-weight: 400;\">Early detection and screening in pharmacies<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Even in otherwise healthy adults, kidney function can decline with age. After age 40, eGFR <\/span><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC10651638\/\"><span style=\"font-weight: 400;\">declines<\/span><\/a><span style=\"font-weight: 400;\"> at approximately 1 mL\/min per year. Although serum creatinine levels may appear normal in patients in their 70s or 80s, kidney function could still be reduced, since older adults have lower muscle mass.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Therefore, it\u2019s important not to rely solely on creatinine and instead calculate eGFR. Pharmacists who have access to patient labs during medication therapy management should always consider the patient\u2019s age and weight when assessing kidney function.\u00a0<\/span><\/p>\n<h3 id=\"risk-factors-to-look-out-for\"><span style=\"font-weight: 400;\">Risk factors to look out for<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Certain patients may have other conditions that could increase their risk of CKD. It may be helpful to keep kidney function in mind when caring for patients with a personal or family history of the following:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/blog\/diabetes-support\/\"><span style=\"font-weight: 400;\">Type 2 diabetes<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Hypertension<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Coronary artery disease<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/blog\/pharmacist-role-in-obesity-management\/\"><span style=\"font-weight: 400;\">Obesity<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Gout<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">HIV<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Patients taking medications for these conditions may be candidates for a conversation about kidney disease. For example, a patient who\u2019s been on lisinopril for years and never mentioned kidney disease may have overlooked discussing kidney function with their healthcare provider. As a pharmacist, you can prompt them to bring this up at their next doctor&#8217;s visit.\u00a0<\/span><\/p>\n<h3 id=\"opportunities-in-point-of-care-testing\"><span style=\"font-weight: 400;\">Opportunities in point-of-care testing<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">With pharmacies offering point-of-care testing services such as blood pressure and blood sugar checks, pharmacists may be able to counsel patients about potential kidney dysfunction. High blood pressure or blood sugar levels may suggest a need for follow-up labs, including serum creatinine, eGFR, and <\/span><a href=\"https:\/\/www.kidney.org\/professionals\/kdoqi\"><span style=\"font-weight: 400;\">urine albumin-to-creatinine ratio (uACR)<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Hospital and clinical pharmacists often have direct access to a patient&#8217;s full lab picture as part of routine care. Therefore, it may be easier to see early trends, such as a declining eGFR on admission, and use that data to recommend dose adjustments.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Regardless of the setting, the uACR is worth keeping on the radar. Proteinuria is one of the earliest detectable signs of kidney damage, but many high-risk patients, especially those with diabetes or hypertension, aren&#8217;t being screened annually as they should be.<\/span><\/p>\n<h2 id=\"counseling-patients-on-kidney-disease\"><span style=\"font-weight: 400;\">Counseling patients on kidney disease<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Patients with kidney disease or at high risk of kidney disease may need special attention from pharmacists in both clinical and retail settings. Pharmacists can help make sure patients have the information they need between healthcare provider visits.<\/span><\/p>\n<h3 id=\"review-medications-at-every-visit\"><span style=\"font-weight: 400;\">Review medications at every visit\u00a0<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Many patients are on several medications, with more than four in 10 older adults taking <\/span><a href=\"https:\/\/lowninstitute.org\/projects\/medication-overload-how-the-drive-to-prescribe-is-harming-older-americans\/\"><span style=\"font-weight: 400;\">five or more<\/span><\/a><span style=\"font-weight: 400;\"> prescription medications. These medications can change between provider visits, so it\u2019s important to monitor how these drugs affect kidney health. Pharmacists can then recommend dosage adjustments or other medication changes.\u00a0<\/span><\/p>\n<h3 id=\"educate-patients-on-the-signs-of-worsening-kidney-function\"><span style=\"font-weight: 400;\">Educate patients on the signs of worsening kidney function\u00a0<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Many patients are unaware of how kidney disease progresses. Signs of worsening kidney function may include edema in the legs or ankles, persistent fatigue, foamy urine, and decreased urine output. All of these may be potential red flags to mention to a provider.\u00a0<\/span><\/p>\n<h3 id=\"remind-patients-about-regular-kidney-function-testing\"><span style=\"font-weight: 400;\">Remind patients about regular kidney function testing\u00a0<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Many patients often need regular lab visits, especially those with hypertension or diabetes. However, a lot of them may be skipping their yearly lab tests. A quick <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/how-to-build-a-pharmacist-patient-relationship\/\"><span style=\"font-weight: 400;\">reminder from a pharmacist<\/span><\/a><span style=\"font-weight: 400;\"> can help patients stay on track with regular kidney function testing and catch potential problems early.\u00a0<\/span><\/p>\n<h3 id=\"mention-lifestyle-changes-that-support-kidney-health\"><span style=\"font-weight: 400;\">Mention lifestyle changes that support kidney health\u00a0<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Patients with CKD may need to be reminded about certain lifestyle changes to support kidney health. That might include keeping blood pressure and blood sugar levels in check, limiting sodium intake, <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/encouraging-physical-activity-in-patients\/\"><span style=\"font-weight: 400;\">staying active<\/span><\/a><span style=\"font-weight: 400;\">, and avoiding smoking to help curb the progression of CKD.\u00a0<\/span><\/p>\n<h3 id=\"counsel-on-potential-risks-of-otc-drugs\"><span style=\"font-weight: 400;\">Counsel on potential risks of OTC drugs<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Counseling on OTC medications is one of the most impactful ways for pharmacists to help patients improve kidney health. For example, patients with CKD typically need to avoid NSAIDs like ibuprofen or naproxen for pain relief. Instead, you might recommend acetaminophen. It\u2019s also important to ask about <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/medicinal-plants-in-pharmacy\/\"><span style=\"font-weight: 400;\">herbal supplements<\/span><\/a><span style=\"font-weight: 400;\"> patients may be taking, since some, including those that contain aristolochic acid, can be nephrotoxic.\u00a0<\/span><\/p>\n<h2 id=\"bottom-line\"><span style=\"font-weight: 400;\">Bottom line<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">While kidney disease is a silent condition that can affect millions of Americans, pharmacists can do their part to help prevent or manage it. Whether it\u2019s in a community pharmacy, hospital, or clinic, pharmacists have direct contact with patients who may not be aware of potential kidney risks. Medication management, education, and OTC counseling are all ways patients can get the information they need to protect their kidney health long-term.\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Kidney disease is a progressive condition that many patients live with, sometimes without even knowing they have it. As vital organs, the kidneys are key points for monitoring dosages, drug interactions, and potential nephrotoxic effects.\u00a0 Pharmacists can be valuable in advising patients on kidney health, especially by adjusting medications and flagging harmful drug interactions. Picking [&hellip;]<\/p>\n","protected":false},"author":135,"featured_media":635744,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[9340],"tags":[790,743],"coauthors":[8669],"class_list":["post-635723","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-the-checkout","tag-chronic-disease","tag-pharmacies","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>The pharmacist\u2019s role in kidney health<\/title>\n<meta name=\"description\" content=\"Pharmacists can improve kidney health by focusing on early detection, drug risks, and NSAID guidance. 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