Overview of the PRN

The Nephrology PRN includes pharmacists and trainees focused on optimizing the care of patients with a spectrum of kidney conditions. The PRN is a tightknit group of around 200 members from academia, clinical practice, and the pharmaceutical industry.

Engagement Opportunities and Resources

Many of the PRN’s committees offer opportunities to trainees, including the Member Advocacy, Research, and Nominations committees. Trainees are encouraged to participate in the PRN’s monthly webinar series. These include journal club, research-in-progress, and therapeutic update topics and are a great way to get involved and give a national presentation. Matt Horton, Pharm.D., the current PGY2 nephrology pharmacy resident at the VA San Diego Healthcare System, commented about his recent webinar presentation and his involvement with the Nephrology PRN:

I had the great opportunity to present a journal club on the CREDENCE trial to the Nephrology PRN. I shared the idea that SGLT2 inhibitors have several beneficial outcomes in terms of their renoprotective effects that are independent from the management of diabetes. In addition, there are plenty of opportunities to continue learning within the PRN such as the monthly webinar series and an e-mail forum with experts and leaders. It has been rewarding to see pharmacists from the Nephrology PRN lead workshops at both ACCP and other international medical conferences. I thank the PRN for allowing me to contribute to their continued growth.

The Nephrology PRN also offers a $500 trainee travel award to support attendance at the ACCP Annual Meeting, where attendees can present their research at the PRN business meeting. In addition, the PRN maintains a curated list of PRN members with areas of expertise and contact information to facilitate research collaborations. Trainees are encouraged to join the Nephrology PRN and get involved! Join a PRN committee, present a webinar, or come to the PRN’s business meeting at the ACCP Annual Meeting. PRN members would love to connect with you!

Current Clinical Issue

Sodium-glucose cotransporter 2 (SGLT2) inhibitors have been in the antidiabetic armamentarium for many years, but new data analyses show that they protect against renal function decline in patients with diabetes as well. Randomized, placebo-controlled clinical trials show that empagliflozin (EMPA-REG OUTCOME), dapagliflozin (DECLARE-TIMI 58), and canagliflozin (CREDENCE) all slow the progression or delay the onset of diabetic nephropathy.^1-3 In each study, most patients were already receiving angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, indicating that adding SGLT2 inhibitors provides more renal benefit than the standard of care. The adverse effect profile of SGLT2 inhibitors is somewhat of concern because it includes genital and urinary tract infections, euglycemic ketoacidosis, and increased risk of limb amputation. These risks need to be weighed against the favorable effects on lowering blood glucose and blood pressure and improving cardiovascular mortality in addition to improving renal outcomes. Pharmacists are well positioned to serve as the transitional provider between primary care, endocrinologists, and nephrologists to ensure the safe and effective use of these agents for patients with diabetes.

Written by: Calvin J. Meaney, Pharm.D., BCPS

References:

1. Wanner C, Inzucchi SE, Lachin JM, et al. Empagliflozin and progression of kidney disease in type 2 diabetes. N Engl J Med 2016;375:323-34.
2. Monsenzon O, Wiviott SD, Cahn A, et al. Effects of dapagliflozin on development and progression of kidney disease in patients with type 2 diabetes: an analysis from the DECLARE-TIMI 58 randomised trial. Lancet Diabetes Endocrinol 2019;7:606-17.
3. Perkovic V, Jardine MJ, Neal B, et al. Canagliflozin and renal outcomes in type 2 diabetes and nephropathy. N Engl J Med 2019;380:2295-309.