Four Pillars of CKD Pharmacotherapy: A Practice Framework
This narrative review consolidates KDIGO 2024 guideline-directed therapy for chronic kidney disease into an actionable four-drug-class framework relevant to every pharmacist managing renal patients.
Four drug classes redefine CKD pharmacotherapy, needing nurse collaboration.
Chronic kidney disease (CKD) management now includes new drug classes that slow disease progression and reduce cardiovascular risk, making effective pharmacotherapy critical. The review identifies four key drug classes: renin-angiotensin system inhibitors, sodium-glucose cotransporter 2 inhibitors, nonsteroidal mineralocorticoid receptor antagonists, and glucagon-like peptide 1 receptor agonists. Nephrology nurses are pivotal in managing these therapies, highlighting the need for education on pharmacotherapy and addressing barriers like medication access. Pharmacotherapy in CKD now relies on four essential drug classes that require interdisciplinary collaboration for effective management.
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Citation:Laub MR, Condon Martinez AJ Standard of Care for Chronic Kidney Disease: The Four Pillars of Pharmacotherapy - Implications for Nephrology Nursing Practice. Nephrology nursing journal : journal of the American Nephrology Nurses' Association. 2026;53(4):319-390.
Subscribers receive access to a complete clinical analysis, available online and as a downloadable PDF.
Executive Summary
Study Design
Patient Population
Primary Outcomes
Secondary Outcomes & Safety Profile
Pharmacist Implications
Clinical Pearls
Limitations
Controversies & Evidence Gaps
Cost & Logistics
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