7.5. Drugs used in Chronic Kidney Disease
7.5.1. Mineralocorticoid Receptor Antagonists
7.5.2. Sodium-glucose co-transporter 2 (SGLT2) inhibitors
Restrictions:
Chronic Kidney Disease:
- Restricted to initiation by clinicians, either in primary or secondary care, experienced in the treatment of chronic kidney disease (CKD) for use in patients with an estimated glomerular filtration rate of ≥25 to ≤75 mL/min/1.73m2 at treatment initiation, who are receiving an angiotensin converting enzyme inhibitor or angiotensin receptor blocker (unless these are not tolerated or contraindicated), and have a urine albumin-creatinine ratio of at least 23mg/mmol and/or type 2 diabetes mellitus.
For use in chronic heart failure, see section 2.5.6
7.5.3. Cation exchange compound
Restrictions:
Restricted to specialist initiation in patients with hyperkalaemia (serum potassium >6.0mmol/L) with chronic kidney disease (CKD) stage 3b to 5 and/or heart failure who would otherwise need to downtitrate or discontinue their renin-angiotensin-aldosterone system inhibitor (RAASi) therapy to maintain a clinically acceptable serum potassium level.
Prescribing Notes:
Please refer to section 9.2.1.1 for treatment of acute, life-threatening hyperkalaemia.
Restrictions:
Restricted to specialist initiation in patients with hyperkalaemia (serum potassium >6.0mmol/L) with chronic kidney disease (CKD) stage 3b to 5 and/or heart failure who would otherwise need to down-titrate or discontinue their renin-angiotensin-aldosterone system inhibitor (RAASi) therapy to maintain a clinically acceptable serum potassium level.
Prescribing Notes:
Please refer to section 9.2.1.1 for treatment of acute, life-threatening hyperkalaemia.