Pharmacists Are Indispensable in Managing Chronic Kidney Disease

In an interview with Pharmacy Times®, Pranav Garimella, MBBS, MPH, chief medical officer of the American Kidney Fund and board-certified nephrologist at UC San Diego Health, highlights the indispensable role of pharmacists in the management of chronic kidney disease (CKD) and related comorbidities. Garimella explains that patients with advanced kidney disease often manage multiple daily medications, making pharmacist involvement crucial for education, refill coordination, and ensuring coverage and affordability. Garimella notes that pharmacists in multidisciplinary CKD clinics collaborate closely with nephrologists to optimize prescriptions, identify drug interactions, and monitor for adverse events. He underscores that pharmacists are as vital to patient care as physicians, playing a central role in improving outcomes for those with complex conditions.

This transcript was edited for grammar and clarity using artificial intelligence.

Pharmacy Times: What is the value of the pharmacist in this setting?

Pranav Garimella, MBBS, MPH: Pharmacists play a critical role in the management of kidney disease. Many patients, especially those with advanced kidney disease and kidney failure, take anywhere from five to fifteen medications a day. Patients need to be educated about these medications—how to take them, when to take them, and even when to stop them.

In our practice, we have pharmacists working every day with dialysis patients, making sure that patients have enough refills, know when to ask for refills, and that their insurance providers are covering these medications. In our multidisciplinary CKD clinic, every time a patient comes in to meet with a clinician or nephrologist, they also see a pharmacist to ensure they have the medications they need, that we’re prescribing appropriately, and that patients can afford and adhere to their treatments.

As we’ve said, this is a team effort, and pharmacists are incredibly important in the management of complex medical conditions. In chronic kidney disease and other conditions such as heart failure and cancer, the pharmacist is just as vital as any other member of the care team, including the physician. I wouldn’t be able to successfully take care of my patients without our pharmacy team. I regularly consult with them, especially regarding new medications, to understand drug interactions and mechanisms of action, and to ensure adverse events are properly documented and reported to the authorities.