{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T07:11:31Z","timestamp":1761808291594,"version":"3.40.5"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,4,30]],"date-time":"2019-04-30T00:00:00Z","timestamp":1556582400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Renin\u2010angiotensin system (RAS) inhibitors carry a risk of normotensive ischemic acute kidney injury in dehydration and concurrent nonsteroidal anti\u2010inflammatory drug (NSAID) use. Although the estimated number of patients with chronic kidney disease (CKD) is 20\u00a0000, Fujieda, Japan, has only three nephrologists. On 25 March 2016, we reorganized the CKD network to include pharmacists and distributed a CKD manual. We assessed effects of pharmacist participation in the CKD network and CKD manual distribution on patient hospitalizations because of drug\u2010related kidney injury.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Changes in the prevalence of RAS inhibitor\u2013related estimated glomerular filtration rate (eGFR) declines of greater than or equal to 30% and hyperkalemia of greater than or equal to 6.0\u00a0mEq\/L in 129 hospitalized CKD patients, drug prescriptions of 14\u00a0150 hospitalized patients, and annual medical checkup data in 36\u00a0042 citizens were investigated before and after pharmacist participation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After pharmacist participation, patient hospitalizations due to RAS inhibitor\u2013related eGFR declines decreased (71.4% to 38.1%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.03) and hyperkalemia declined (38.1% to 9.5%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.03). Pharmacist participation influenced the decrease in RAS inhibitor\u2013related eGFR declines (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.03). NSAID prescriptions decreased (13.4% to 11.8%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.003) and acetaminophen prescriptions increased (6.6% to 8.0%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.002) among 14\u00a0150 hospitalized patients, whereas RAS inhibitor prescriptions decreased (43.2% to 39.4%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.002) among 6930 hospitalized patients with eGFR less than 60\u00a0mL\/min\/1.73\u00a0m<jats:sup>2<\/jats:sup>. A significant number of citizens shifted from CKD stage G3a\u20103b to G1\u20102.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Pharmacist participation in the CKD network and CKD manual distribution decreased both hospitalizations due to RAS inhibitor\u2013related kidney injury and citizens with CKD stage G3a\u20103b.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.4787","type":"journal-article","created":{"date-parts":[[2019,5,1]],"date-time":"2019-05-01T02:42:04Z","timestamp":1556678524000},"page":"887-896","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Effects of pharmacist participation in chronic kidney disease (CKD) network and CKD manual distribution on drug\u2010related kidney injury"],"prefix":"10.1002","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6340-0376","authenticated-orcid":false,"given":"Tatsuo","family":"Yamamoto","sequence":"first","affiliation":[{"name":"Department of Nephrology Fujieda Municipal General Hospital  Fujieda Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isao","family":"Nakayama","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Fujieda Municipal General Hospital  Fujieda Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yutaro","family":"Kawakatsu","sequence":"additional","affiliation":[{"name":"Department of Nephrology Fujieda Municipal General Hospital  Fujieda Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takumi","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Nephrology Fujieda Municipal General Hospital  Fujieda Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoyuki","family":"Ishigami","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Fujieda Municipal General Hospital  Fujieda Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kei","family":"Watanuki","sequence":"additional","affiliation":[{"name":"Department of Oral Surgery Fujieda Municipal General Hospital  Fujieda Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takayoshi","family":"Okabe","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Fujieda Municipal General Hospital  Fujieda Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hidetaro","family":"Yokoyama","sequence":"additional","affiliation":[{"name":"Medical Department Seiryo Rehabilitation Hospital  Fujieda Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,4,30]]},"reference":[{"issue":"8","key":"e_1_2_9_2_1","first-page":"1034","article-title":"Special issue: clinical practice guidebook for diagnosis and treatment of chronic kidney disease 2012","volume":"54","author":"Japanese Society of Nephrology","year":"2012","journal-title":"Nihon Jinzo Gakkai Shi"},{"issue":"1","key":"e_1_2_9_3_1","first-page":"1","article-title":"Kidney disease: improving global outcomes. 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