Health professionals are reminded to tread cautiously when treating acute illness in patients with chronic conditions, in an article published in the latest edition of Australian Prescriber.
Patients with chronic conditions such as diabetes and chronic kidney disease could be at increased risk during periods of intercurrent illness, known as ‘sick days’. The article explains the importance of understanding pharmacokinetic factors associated with ‘sick days’ in predicting and managing these risks.
“Patients with chronic kidney disease may be at particular risk of problems because conditions that induce hypovolaemia increase the risk of acute kidney injury in those with reduced renal homeostatic reserve,” say the authors, Drs Tom Lea-Henry, Jonathan Baird-Gunning and Darren Roberts, with pharmacist Elizabeth Petzel, from Canberra hospital.
“The risk is compounded if the patient is taking drugs that compromise renal function, such as diuretics and ACE inhibitors.”
Patients with diabetes should increase their glucose monitoring on sick days. In those taking insulin, the dose may need to be increased.