october 2009

October 2009

HISTORY OF THE NEPHROLOGY PRACTICE AND RESEARCH NETWORK Purpose: To document the history of the Nephrology PRN (NephPRN).

Methods: E-mails and telephone calls to current and former members of the NephPRN were begun in

February 2008, soliciting historical information about the formation and activities of the NephPRN. A

draft outline was presented at the April 2008 meeting. Several drafts of the paper were circulated by e-

mail for review, contributions, and comments. More than 20 current and former NephPRN members and

ACCP staff contributed information for the paper. The final draft was presented at the April 2009

meeting, together with the first poster draft.

Results: The NephPRN was formed in 1993 with 73 initial members. Gary Matzke was the first elected

chair. Current membership is around 180. Formal and ad hoc committees have actively pursued their

charges; several publications have resulted from committee projects. Preceptors have trained more than

75 health care professionals in programs including residencies, fellowships, degree programs, and mini-

sabbaticals. The NephPRN has hosted, or collaborated with other PRNs on, 19 educational programs at

ACCP. NephPRN members have planned and/or presented at other nephrology meetings, including

NKF, and are actively involved in federal programs serving patients with kidney disease. NephPRN

members have been awarded NIH grants and distinguished awards within ACCP and other

organizations. At last count, 20 NephPRN members were Fellows of ACCP.

Conclusion: The NephPRN has been, and will continue to be, a welcoming group within ACCP, focused

on serving health care professionals and patients through research, training, patient advocacy, and direct

patient care initiatives.

History of the Nephrology PRN

June 2009

Table of Contents

Background ............................................................................................................................... 4

Formation, Membership, and Leadership of the Nephrology PRN......................................... 4

Mission Statement and Objectives......................................................................................... 5

Commitment to Lifelong Learning.............................................................................................. 6

Residency, Fellowship, and Ph.D. Programs......................................................................... 6

Building Diverse Educational Opportunities for ACCP ........................................................... 9

Mini-Sabbaticals................................................................................................................... 13

Awards and Named Posts ....................................................................................................... 14

American College of Clinical Pharmacy ............................................................................... 14

American Association of Colleges of Pharmacy................................................................... 15

American Society of Health-System Pharmacists ................................................................ 15

National Academies of Practice ........................................................................................... 16

United States Pharmacopeia ............................................................................................... 16

U.S. Food and Drug Administration ..................................................................................... 16

Nephrology PRN Members Who Are Fellows of ACCP........................................................... 17

Committees Make the PRN-Go-Round.................................................................................... 17

Communication Committee (newsletters/Web site) ............................................................. 17

Membership Committee ....................................................................................................... 18

Programming Committee ..................................................................................................... 18

Research Committee ........................................................................................................... 18


June 2009

Education Committee........................................................................................................... 19

Nominations Committee....................................................................................................... 20

Ad Hoc Committees and Special Projects............................................................................ 20

Involvement with National Kidney Foundation ......................................................................... 22

Reflective Statements.............................................................................................................. 23

Vision for the Future ................................................................................................................ 25

APPENDIX 1: Selected Nephrology PRN Abstracts and Posters............................................ 27

APPENDIX 2: Contributors ...................................................................................................... 28

List of Tables

Table 1 Nephrology PRN Chairs ............................................................................................ 4

Table 2 Nephrology Preceptors and Fellows, Residents, Masters, and Ph.D. Students ........ 7

Table 3. Nephrology PRN Programming at ACCP Meetings .................................................. 9

Table 4. Mini-Sabbaticals...................................................................................................... 13

Table 5. Nephrology PRN Members Who Are Fellows of ACCP........................................... 17

Table 6. Medication/Medication Category Reviewers ........................................................... 21


June 2009

Background

Formation, Membership, and Leadership of the Nephrology PRN

The Nephrology Practice and Research Network (PRN) was formally approved by ACCP in

February 1993, with 73 initial members. The first elected chair was Gary Matzke; subsequent

chairs are listed in Table 1. The first business meeting was held on February 8, 1993, at the

ACCP Winter Forum. In the ensuing 15 years, the membership increased to more than 200

members from the United States, Canada, and other countries. Membership as of March 2009

is 183 members. One hundred thirty-six of the Nephrology PRN members are board certified

through the Board of Pharmaceutical Specialties.

Table 1 Nephrology PRN Chairs

Years Chair Years Chair

1993–1994 Gary Matzke 2002–2003 Naomi Dahl

1994–1995 Arasb Ateshkadi 2003–2004 Joanna Hudson

1995–1997 Nancy Mason 2004–2005 Thomas Dowling

1997–1998 Michael Marx 2005–2006 Amy Barton Pai

1998–1999 Tom Comstock 2006–2007 Harold Manley

1999–2000 Edward Foote 2007–2008 Darren Grabe

2000–2001 Michelle (Chapman) Richardson 2008–2009 Ruth Ann Subach

2001–2002 Melanie Joy 2009–2010 Sarah Tomasello

2010–2011 Thomas Nolin

Note: Contents of Table 1 were verified with ACCP records.

The following people have served as ACCP Board Liaisons for the Nephrology PRN: Robert

Elenbaas, Lawrence Hak, Kathleen Lake, Gary Matzke, Bruce Mueller, and Nancy Perrin.


June 2009

Mission Statement and Objectives

The current mission statement of the Nephrology PRN, as included in our newsletter, is as

follows:

1. To advance the scope of nephrology pharmacotherapy through excellence in education,

clinical practice, research, and involvement in professional nephrology organizations;

and

2. To ensure optimal patient outcomes.

The objectives of the Nephrology PRN are to:

1. Promote and enhance nephrology pharmacy as a credible and critical practice among

a. PRN members,

b. pharmacists,

c. health care professionals,

d. renal patients, and

e. the public;

2. Establish and maintain an effective level of communication between its members;

3. Foster model clinical pharmacy practices in nephrology;

4. Develop a model curriculum of nephrology pharmacotherapy for pharmacy students;

5. Undertake collaborative research and disseminate the results by publication and oral

presentation; and

6. Encourage its members to provide optimal patient care and pharmacoeconomic

outcomes.


June 2009

Commitment to Lifelong Learning

Residency, Fellowship, and Ph.D. Programs

The Nephrology PRN members have been dedicated to the recruitment, training, and support

of residents, fellows, and graduate students throughout the PRN’s existence. Success of

trainees has been demonstrated by obtaining faculty positions (clinical, basic science, and

administrative positions), clinical practice positions (in a variety of settings), administrative

positions, and pharmaceutical industry and contract research organization positions, where

sustained contributions to the practice of nephrology pharmacy, education, and research have

been documented. Trainees have demonstrated their commitment to patient care, have gone

on to become preceptors for others, have applied sound research principles regardless of

setting, and have given service to the Nephrology PRN and ACCP at-large. Table 2

summarizes preceptors and trainees of nephrology residency, fellowship, master’s of science,

and Ph.D. programs.


June 2009

Table 2 Nephrology Preceptors and Fellows, Residents, Masters, and Ph.D.

Students

Preceptor Fellows, Residents, Master’s of Science, and Ph.D. Students

George Bailie Rowland Elwell (F, 1998–2000)

Darren Grabe (F, 1996–1998)

Chai Luan Low (F, 1993–1995)

Harold Manley (F, 1997–1999)

Donald Brophy Lori Wazny (F, 1998–2000)

Thomas Comstock Joanna Hudson (F, 1996–1998)

Thomas Dowling Tahira Igbal (F, 2002–2003)

Chetan Karyekar (P, 1999–2002)

Minori Kinjo (P, 2004–2008)

Ghazal Vessal (F, 2006–2008)

Edward Foote Naomi Dahl (F, 1996–1998)

Omaira Melendez (F, 1998–2000)

Adel Rizkala (R, 1999–2001)

Calbert Valencia (R, 2000–2001)

Darren Grabe Katie Pelota (F, 2006–2008; co-precepted by Harold Manley)

Curtis Johnson Arasb Ateshkadi (F, 1991–1993)

Claude Taylor III (F, 1993–1996)

Alan Lau Priscilla How (F, 2005–2007)

Sonia Lin (F, 1998–2000)

Kwanta Na-Thalang (F, 2002–2004)

Darius Mason (F, 2006–2008)

Amy Barton Pai (F, 1999–2001)

Somratai Ratisoontorn (F, 1998–1999)

Patcharaporn Sudchada (F, 2004–2006)

Ignatius Tang (F, 1986–1988)

Harold Manley Debra Overbay (R, 2001–2002)

Katie Pallotta (F, 2006–2008; co-precepted by Darren Grabe)

Michael Marx Rhonda Radabaugh (F, 1999–2001)

Ruth Ann Subach (F, 1997–1999)

Gary Matzke Alicia C.M. Alexander (F, 1993–1995)

Leendert Bakker (R, 1986–1987)

Thomas Dowling (P, 1994–1999)

Reginold F. Frey (P, 1990–1991)

Charles E. Halstenson (R, 1982–1983)

Karen L. Heim-Duthoy (F, 1983–1985)

Cheryl Hirata-Dulas (F, 1987–1989)

Melanie S. Joy (F, 1993–1995)


June 2009

John M. Kovarik (F, 1985–1987) Continued

David R. Luke (F, 1985–1987)

Francis Ndemo (R, 1986)

Thomas Nolin (P, 1997–2003)

Stephen P. Millikin (F, 1988–1990)

Mary E. O’Connell (R, 1983–1984)

Michael Schwenk (F, 1987–1989)

John V. St. Peter (R, 1988–1989)

Bruce Mueller Dennis G. Brierton (R, 1991–1992)

Donald F. Brophy (R, 1995–1996)

Mariann Churchwell (F, 2003–2005)

Marigel Vargas-Ruiz Constantiner (M, 1990–1992)

Maricor Grio (F, 2005–2007)

Patrick J. Heffernan (M, 1990–1991)

Aroonrit Lucksiri (P, 1999–2000)

Erle Douglas Murphey (M, 1993–1995)

Deborah A. Pasko (F, 2001–2003)

Jignesh Patel (F, 2005–2007)

Noha Salama (F, 2007–2008)

Meri Kay Scott (P, 1993–1997)

Niyati Shah (M, 1998–1999)

Mary Vilay (F, 2007–2009)

Sheryl L. Follin Vondracek (R, 1994–1995)

Amy Barton Pai Todd Connor (F, 2006–2008)

Joseph Depczynski (R, 2003–2004)

Isela Martinez (R, 2004–2005)

Wendy St. Peter Cindy (Yen-Wen) Chen (P, 2007–present)

Jennifer Clark (R, 1996–1997)

Marigel Constantiner (R, 1992–1993)

Holly Epperly (P, 2008–present)

Daniel Kennedy (R, 1995–1996)

Lawrence Lambrecht (R, 1993–1994)

Matthew Lewis (R, 1995–1996)

Ondrea Levos (R, 1996–1997)

Martin Meese (R, 1989–1990)

Scott Milhalovic (R, 1993–1994)

Jacqueline Nolin (R, 1991–1992)

Kimberly Redic (R, 1990–1991)

Gail Rubinstein (R, 1994–1995)

Xin Ye (P, 2004–2006)

Sarah Tomasello Mary Barna (R, 2007–2008)

Legend: F = Fellow; M = master’s degree; P = Ph.D.; R = resident.


June 2009

Building Diverse Educational Opportunities for ACCP

The Nephrology PRN has hosted and collaborated with other PRNs on numerous PRN focus

sessions and premeeting symposia at ACCP meetings and at the ACCP/ESCP International

Congress of Clinical Pharmacy meetings. World-renowned experts in nephrology medicine

have joined us in these presentations. In 1999, the Nephrology PRN hosted a program at the

first ACCP/ESCP meeting, titled “Progression of Renal Disease: Perspective for Clinical

Management.” Most recently, collaboration with the Critical Care PRN led to a well-attended

premeeting symposium titled “Controversies in Critical Care Nephrology.” In October 2009, a

PRN focus session exploring and documenting the role of the pharmacist in ensuring the

appropriate transition of care to and from the inpatient or outpatient setting will be presented,

and our collaboration with the Ambulatory Care PRN continues into 2010 with a proposed joint

program about vitamin D. Table 3 summarizes these programs.

Table 3. Nephrology PRN Programming at ACCP Meetings

Meeting Programming

August 1995 Annual Meeting

Advances in the Management of Renal Disease

• Reina Bendayan; Clinical Importance of Renal Drug Transport

• Lawrence Hak; Progression of Renal Disease: Effects of Dietary Protein Restriction

• Wendy St. Peter; Delaying the Progression of Renal Disease with Antihypertensive Drug Therapy

• Moderated by Sylvie Robert

August 1996 Annual Meeting

Insights into the Treatment of Acute Renal Failure (collaborated with Critical Care PRN)

• Edward Foote; Drug Therapy for Preservation of Renal Function After Ischemic Injury

• Bruce Mueller; Renal Replacement Therapies in the ICU: Focus on Hemofiltration

• Moderated by Catherine Verme

April 1997 Spring Practice and Research Forum

Updates in Renal Osteodystrophy

• Wendy St. Peter; Comparison of Phosphate Binding Agents in Treatment of Renal Osteodystrophy

• Nancy Mason; Pharmacokinetic and Pharmacodynamic Properties of Vitamin D Analogs

• Alan Lau; New Vitamin D Analogs and Investigational Agents for Treating Osteitis Fibrosa Cystica

• Moderated by Wendy St. Peter

November 1998 Annual Meeting

Challenging Cases in Nephrology

• Cases presented by Gary Matzke, James Winchester, and Michael Marx

• Moderated by Michael Marx

Continued


June 2009

April 1999 International Congress of Clinical Pharmacy

Progression of Renal Disease: Perspective for Clinical Management

• Thomas Comstock; Etiology, Diagnosis, and Mechanisms for the Progression of Renal Disease

• Lawrence Hak; Therapeutic Strategies Directed at Proteins and Lipids to Prevent Progressive Renal Insufficiency

• Bertram Kasiske, M.D.; Treatment of Progressive Nephropathy in Patients with Diabetes and Hypertension: Aspects of Clinical Practice

• Moderated by Cecilia Shott

October 1999 Annual Meeting

Progress in Hemodialysis Access

• Anatole Besarab, M.D.; Dialysis Access: What Are the Options

• Michelle (Chapman) Richardson; Assessing the Integrity of Dialysis Access: The Role of Mechanical Thrombectomy and Thrombolytic Therapy

• Richard Dew; Access-Related Infections

• Moderated by Thomas Comstock


Cardiovascular Risk Factors in Patients with Chronic Renal Failure: How Should They Be Managed?

• Edward Foote; The National Kidney Foundation’s Cardiovascular Disease in Chronic Renal Disease Task Force Report

• Joanna Hudson; Focus on Hypertension: Pharmacotherapy in Patients with Chronic Renal Disease

• Naomi Dahl; Focus on Hyperlipidemia: Pharmacotherapy in Patients with Chronic Renal Disease

• Moderated by Michelle (Chapman) Richardson


Diabetic Nephropathy (collaborated with Ambulatory Care PRN)

• Lawrence Hunsicker, M.D.; The Pathophysiology of Diabetic Nephropathy

• Julie Oki; The Pharmacist’s Role in Screening for Microalbuminuria

• John Burke; Treatment Options for Diabetic Nephropathy

• Moderated by Edward Foote


Significant Papers in Nephrology

• Lori Wazny; Renal Anemia Management

• Ruth Ann Subach; Renal Osteodystrophy

• Melanie Joy; Continuous Renal Replacement Therapy

• Harold Manley; Peritoneal Dialysis

• Thomas Dowling; Progression of Renal Disease

• Mary Stamatakis; Pharmacotherapy of Acute Renal Failure

• Moderated by Michelle (Chapman) Richardson


Anticoagulation in Renal Failure

• Donald Brophy; Anticoagulation in Patients with Compromised Renal Function

• Ruth Ann Subach; Anticoagulation During Continuous Renal Replacement Therapy

• Melanie Joy; Using Direct Thrombin Inhibitors in Patients Requiring Renal Replacement Therapy

• Moderated by Thomas Dowling


Ethnic and Gender Disparities in the Progression of Chronic Kidney Disease

• Joanna Hudson; Hypertension-Related Chronic Kidney Disease

• Patrick Nachman; Glomerular Disease-Related Chronic Kidney Disease

• Melanie Joy; Gender-Related Effects of Chronic Kidney Disease Progression

• Moderated by Naomi Dahl Continued


June 2009


Update on the National Kidney Foundation K/DOQI Clinical Practice Guidelines for Chronic Kidney Disease

• Rowland Elwell; Overview of National Kidney Foundation K/DOQI Clinical Practice Guidelines for Chronic Kidney Disease

• Darren Grabe; Association of Severity of Chronic Kidney Disease and Development of Secondary Complications

• Melanie Joy; Applying the NKF Guidelines for Chronic Kidney Disease: An Opportunity to Expand Pharmacist’s Roles

• Moderated by Joanna Hudson


Advances in Acute Renal Replacement Therapy

• H. David Humes, M.D.; The Bioartificial Kidney

• Michael Marx; Overview of Continuous Renal Replacement Therapy Methods and Drug Dosing

• Deborah Pasko; Anticoagulation Issues in Continuous Renal Replacement Therapy

• Moderated by Thomas Dowling


Cardiovascular Implications of Chronic Kidney Disease (collaborated with Cardiology PRN)

• Vandana Menon; Kidney Disease as a Risk Factor for Cardiovascular Disease

• Joseph Saseen; Hypertension and Lipid Management Strategies in CKD Patients: Interpretation of New K/DOQI Guidelines

• William Dager; Managing Hypercoagulable States in CKD Patients

• Moderated by Joanna Hudson


New Approaches to Quantifying Renal Function

• Thomas Dowling; Overview of Various Methodologies of Renal Assessment

• Lawrence Hak; Modification of Diet in Renal Disease Method of Assessing Renal Function and Its Role in Special Patient Population

• Michael Winter: Applying MDRD Method of Renal Assessment and Drug Dosing to Clinical Practice and Research Setting

• Moderated by Thomas Comstock


Current Therapeutic Options for the Prevention of Contrast-Induced Nephropathy

• Marcus Ferrone; Contrast-Induced Nephropathy (CIN): An Informed Practitioner

• Thomas Barrs; Which Patient Populations Are at Risk for Developing CIN?

• David Parra; Strategies for Management and Prevention of CIN

• Moderated by Edwin Walton


Pharmacokinetics and Drug Dosing in Patients with Kidney Disease

• Thomas Nolin; Overview of Pharmacokinetic Alterations in Chronic Kidney Disease

• Gary Matzke; Pharmacokinetic and Pharmacodynamic Considerations in the Design of Pharmacotherapy Regimens for Patients with CKD Including Those on Dialysis

• William Dager; Monitoring and Adjusting Pharmacotherapy in Acute Renal Failure

• Moderated by Ruth Ann Subach

Continued


June 2009


The Emergent Role of the Pharmacist in the Management of Pharmacotherapy for Chronic Kidney Disease Patients

• Melanie Joy; Chronic Kidney Disease (CKD) Awareness and Pharmacist Involvement in Caring for CKD Patients Including Dialysis

• Harold Manley; Understand Complete Chronic Kidney Disease Patient: Co-morbidity, Complex Pharmacotherapy Regimen, and Medication-Related Problems

• Wendy St. Peter; What’s Next for Pharmacist Involvement in the Care of Patients with Chronic Kidney Disease?

• Moderated by Naomi Dahl


Controversies in Critical Care Nephrology Premeeting Symposia (collaborated with Critical Care PRN)

• Thomas Dowling; Applying Definitions of Acute Renal Failure in Critically Ill Patients

• Thomas Nolin and William Dager; Pro/Con Debate: MDRD vs. CrCl to Assess Renal Function in Critically Ill Patients

• Thomas Dowling; Methods to Prevent/Reduce Renal Dysfunction in the Critically Ill

• Mariann Churchwell; Modes of Renal Support

• William Dager; Drug Dosing Strategies for Renal Support

• Ty Hiser; Anticoagulant Strategies for Renal Support

• Michael Bentley and Robert MacLaren; Cases

• Ty Kiser; Hepatorenal Syndrome

• Thomas Nolin; Influence of Kidney Disease and Renal Replacement Therapy on Hepatic Function

• Mariann Churchwell; Nutritional and Electrolyte Issues During Renal Dysfunction and Support

• Moderated by Michael Bentley and Robert MacLaren

October 2009 Clinical Pearls for Bridging the Gap Between Inpatient and Outpatient Care for Patients with Chronic Kidney Disease – The Roles of the Pharmacist

• Hemodialysis and Peritoneal Dialysis Patients (CKD Stage 5) – Clinical Pearls for Bridging the Gap Between Hospitalization and Outpatient Clinic Care

• Chronic Kidney Disease Patients (CKD Stages 3–4) – Clinical Pearls for Bridging the Gap Between Hospitalization and Outpatient Clinic Care

• Medication Considerations in CKD – Beyond “Drug Dosing”

April 2010 (Proposed)

What’s New with Vitamin D (collaboration with the Ambulatory Care PRN)


June 2009

Mini-Sabbaticals

Members of the Nephrology PRN began hosting and participating in mini-sabbaticals in 2005.

Table 4 summarizes the three mini-sabbaticals offered and completed to date.

Table 4. Mini-Sabbaticals

Preceptor Trainee Topic/Goal/Year Completed

Mueller, Bruce Bentley, Michael The goals of the mini-sabbatical were to develop a broader understanding of the clinical aspects of continuous renal replacement therapies (CRRT), perform in-laboratory experiments, and develop and submit a grant related to this therapy. The primary focus was on the latter two. (2005)

Nolin, Thomas Barton Pai, Amy “Assessment of Aminothiol Concentrations After IV Iron Administration.” The goals of the mini-sabbatical were to develop and apply HPLC analytic skills to the determination of four aminothiols in human plasma. (2007)

O’Connor, Annette Robinson, Renee Improve disease state and treatment information comprehension and use, patient satisfaction, medication adherence, and health outcomes in adolescents with hypertension. (2006)


June 2009

Awards and Named Posts

The following section highlights the accomplishments of Nephrology PRN members by

presenting selected awards and named posts within professional organizations.

American College of Clinical Pharmacy

ACCP Best Practice Award

William Dager (2008)

ACCP Investigator Development Research Awards

Mariann Churchwell, Tom Dowling, Joanna Hudson, Melanie Joy, Amy Barton Pai, and

Wendy St. Peter

ACCP Frontiers Research Awards

Tom Dowling and Melanie Joy

ACCP President

Gary Matzke, 2007–2008 (President-Elect, 2006–2007)

ACCP Research Affairs Committee

Thomas Dowling, Chair, 2006–2007

ACCP Research Institute Trustee

Thomas Dowling, 2007–2010

Gary Matzke, 2002–2005

ACCP Strategic Planning Committee

Gary Matzke, 2006–2008


June 2009

American Association of Colleges of Pharmacy

AACP COD/COF Faculty Workforce Issues Task Force

Gary Matzke, Chair, September 2005–July 2007

AAAS/AACP Congressional Fellowship (September 2003–December 2004)

Gary Matzke (2003–2004)

AACP Congressional Fellow

Gary Matzke (January 2005–December 2005)

AACP Council of Faculties

Gary Matzke, Chair-Elect 2008–2009

AACP New Investigator Program Grant

Joanna Hudson

AACP Teacher of the Year

Thomas Dowling, Joanna Hudson, Alan Lau, and Maria Pruchnicki

American Society of Health-System Pharmacists

Clinical Pharmacy Dialysis Traineeship

Gary Matzke, Chair, Program Development Committee, 1991–1992

Gary Matzke, Chair, Faculty for Clinical Pharmacy Dialysis Traineeship, 1992–1994


June 2009

National Academies of Practice

Gary Matzke: Member, Council of Sections (2007–2009); Co-Chair, Pharmacy section (2007–

2009); Member, Public Policy Committee (2007–2010); Elected Distinguished Practitioner

(2004)

Wendy St. Peter: Elected Distinguished Practitioner (2009)

United States Pharmacopeia

Gary Matzke: Chair, Nephrology and Urology Expert Information Committee (2007–2010);

Member, Medicare Model Guidelines Expert Committee (2007–2010) Nephrology and Urology

Expert Committee (Gary Matzke, Chair; Melanie Joy, Alan Lau)

U.S. Food and Drug Administration

Melanie Joy – Cardiovascular and Renal Drugs Advisory Committee SGE (special government

employee)


June 2009

Nephrology PRN Members Who Are Fellows of ACCP

As of November 2008, 20 members of the current Nephrology PRN had obtained Fellow status

within ACCP. These members are recognized in Table 5.

Table 5. Nephrology PRN Members Who Are Fellows of ACCP

George R. Bailie, Pharm.D., Ph.D., M.Sc., FCCP

Donald F. Brophy, Pharm.D., FCCP, BCPS

William E. Dager, Pharm.D., FCCP, FCCM,

FCSHP

Robert M. Elenbaas, Pharm.D., FCCP

Ronald P. Evens, Pharm.D., FCCP

Edward F. Foote, Pharm.D., FCCP, BCPS

Lawrence J. Hak, Pharm.D., FCCP, BCPS

Melanie S. Joy, Pharm.D., FCCP

Peggy G. Kuehl, Pharm.D., FCCP, BCPS

Kathleen D. Lake, Pharm.D., FCCP, BCPS

Alan H. Lau, Pharm.D., FCCP

Harold J. Manley, Pharm.D., FCCP, FASN, BCPS

Michael A. Marx, Pharm.D., FCCP

Gary R. Matzke, Pharm.D., FCCP

Bruce A. Mueller, Pharm.D., FCCP

Michelle M. Richardson, Pharm.D., FCCP, BCPS

Wendy L. St. Peter, Pharm.D., FCCP, FASN,

BCPS

Larry W. Segars, Pharm.D., DrPH, FCCP, BCPS

Sheryl F. Vondracek, Pharm.D., FCCP, BCPS

Eric T. Wittbrodt, Pharm.D., FCCP, BCPS

Committees Make the PRN-Go-Round

Communication Committee (newsletters/Web site)

The Nephrology PRN began publishing newsletters in September 1995, with Ed Foote serving

as the first editor. A Communication Committee (which at one time consisted of overseeing the

newsletter and the PRN Web site) was formed. Members who served as newsletter leaders in

communications were Tom Gray, Renee DeHart, Ruth Ann Subach, and Amy Barton Pai, and

Mark Mills currently champions the newsletter.

A Nephrology PRN Web page was launched in 1996; however, the Nephrology PRN currently

uses the ACCP-hosted site as its primary Web page.


June 2009

Membership Committee

Members who have served as chair of the Membership Committee are Renee DeHart, Mary

Stamatakis, and currently Katie Pallotta. Past committee members include Maria Pruchnicki,

Helen Losasso, Ted Walton, and Mary Stamatakis.

At one time, when new members joined the Nephrology PRN, a welcome letter and pamphlet

was sent to the new member by the chair of the Membership Committee. This practice has

been abandoned, but the newly energized committee is committed to finding those

pharmacists within and outside ACCP and promoting the support the Nephrology PRN can

provide them within their practice, research, or educational setting.

Programming Committee

Members who have served as chair of the Programming Committee are Cecilia Schott,

Thomas Dowling, Wendy St. Peter, and Timothy Nguyen. Kristi Cavaliere, Michelle (Chapman)

Richardson, Naomi Dahl, Joanna Hudson, Harold Manley, Gary Matzke, Thomas Nolin, Ruth

Ann Subach, Sarah Tomasello, and Peter Zervopoulos have served as Programming

Committee members. Throughout the years, the Programming Committee has developed

alone or in conjunction with other PRNs more than 10 high-quality educational forums at ACCP

meetings. Meeting presentations are outlined in Table 3.

Research Committee

Members who have served as chair of the Research Committee are Melanie Joy, Harold

Manley, Darren Grabe, and Rowland Elwell. Committee members have included Naomi Dahl.

A representative project of the Research Committee was a “Nephrology Drug Surveillance

Network” in which nephrology pharmacists across several sites worked together to document

the types of medications nephrology patients were taking across various geographic locations.

Abstracts and posters generated from this project are listed in Appendix 2.

A committee for two joint manuscripts between the Nephrology and Ambulatory Care PRN

groups was formed, resulting in manuscripts focused on pharmacists and their role in

multidisciplinary health care provision.


June 2009

• Joy MS, DeHart RM, Gilmartin C, Hachey DM, Hudson JQ, Pruchnicki M, Dumo P,

Grabe DW, Saseen J, Zillich AJ. Clinical pharmacists as multidisciplinary healthcare

providers in the management of chronic kidney disease: a joint opinion by the

Nephrology and Ambulatory Care Practice and Research Networks of the American

College of Clinical Pharmacy (ACCP). Am J Kidney Dis 2004;45:1105–18.

• Zillich AJ, DeHart RM, Dumo P, Grabe DW, Saseen J, Joy MS, Hachey DM, Hudson J,

Pruchnicki M. Caring for patients with chronic kidney disease. A joint opinion of the

Ambulatory Care and Nephrology Practice and Research Network of the American

College of Clinical Pharmacy. Pharmacotherapy 2005;25:123–43.

The committee also fine-tuned the Nephrology PRN mini-sabbatical program under the

leadership of Darren Grabe and Renee DeHart. The completed mini-sabbaticals are

summarized in Table 4.

Education Committee

In 1998, Gary Matzke led an ad hoc Model Curriculum Committee, which led to the following

poster presentation and abstract publication:

• Matzke GR, Alexander Cadogan ACM, Korch K. Nephrology education components of

United States Pharm.D. curricula. First International Congress on Clinical Pharmacy.

Orlando, Florida, April 1999, and Pharmacotherapy 1999;19:541.

Sarah Tomasello began chairing this committee when it was separated from the Research and

Education Committee in 2004. This committee conducted a survey of faculty members from

almost every accredited pharmacy school in the United States who were involved in teaching

related to fluid and electrolyte homeostasis, acid-base disturbances, and acute and chronic

kidney disease and the complications of these diseases. The information gathered from the

study includes the background and training of the faculty, the time allotted for each topic, and

the methods of teaching and assessment. Currently, all the information is compiled, and a

manuscript is being prepared and finalized by members of the PRN, including Renee DeHart,

Wendy St. Peter, Katie Pallotta, Sonia Lin, and Gary Matzke.


June 2009

Kara Bozik, Donald Brophy, Renee DeHart, Sonia Lin, Gary Matzke, Mark Mills, Lori Roark,

Renee Robinson, and Eric Wittbrodt have served as members of the Education Committee.

Nominations Committee

Members who have served as chair or co-chair of the Nominations Committee are Michael

Schwenk, Donald Brophy, and J.V. Anandan. Faithfully, the committee has called for

nominations for our PRN chair-elect.

Ad Hoc Committees and Special Projects

CMS ESRD Outpatient Medication Project

In June 2004, End-Stage Renal Disease Network 8, Inc., contracted with the Centers for

Medicare and Medicaid Services (CMS) to review and analyze outpatient medication use in the

ESRD population. Wendy St. Peter and Harold Manley served as technical expert panel (TEP)

members for this project. The primary objectives were to classify common medications used in

ESRD and to identify medications that should be avoided and medications that should be used

with caution in patients with ESRD. This information was to set the stage for further quality

improvement efforts in this area. One week before the TEP convened in 2006 to make its final

recommendations, the USP Model Formulary Guidelines for Medicare Part D were released.

The TEP recognized that for its recommendations to be useful, the USP formulary drug list

needed to be considered and incorporated into the TEP’s final recommendations before they

were released to the renal community. Twenty-two ACCP members (Table 6) stepped up to

the plate to review all medications/medication categories in the USP formulary, and a summary

was created in 3 short weeks. These recommendations have been used by subsequent CMS

TEPs to create standards for quality improvement efforts under Medicare Part D. Nephrology

PRN members were recognized for their outstanding effort by Sheila Mitchell, ESRD

Outpatient Medications Project Coordinator, in a letter to Dr. Barbara Wells, ACCP President

(2006).


June 2009

Table 6. Medication/Medication Category Reviewers

J.V. Anandan

Estella Davis

Thomas Dowling

Edward Foote

Priscilla How

Joanna Hudson

Alan Lau

Matthew Lewis

Sonia Lin

Helen LoSasso

Carol Manierski

Harold Manley

Gary Matzke

Leigh Milburn

Mark Mills

Amy Pai

Adel Rizkala

Wendy St. Peter

Nancy Simon

Patcharaporn Sudchada

Sarah Tomasello

Ted Walton

Mentorship Initiative

Renee DeHart started a mentorship initiative aimed at pairing Nephrology PRN members with

other members with experience similar to their own. Several mentorship pairs were created

through this initiative. One reflection of this experience, which highlights the importance of

being a role model for other ACCP members, even in the absence of a formal training

program, follows.

Ed Foote was my mentor. I was hired straight out of residency to set up a new practice

site in our university-affiliated dialysis program. I had received no formal training in

nephrology, and I was apprehensive about my new job. I think the most valuable thing I

gained from having a mentor was the encouragement Ed gave me as I worked to build

my new practice. He was adamant that pharmacists could make important contributions

in improving care in dialysis patients and helped me out early on by providing me with

some protocols and patient information sheets that he used. While I didn’t call on him

very much after I got somewhat established, it was nice to have an expert in my pocket,

so to speak, that I knew I could rely on to help me out in difficult situations.

–Heather Nyman


June 2009

Involvement with National Kidney Foundation

This section serves as one example of the extent of involvement of Nephrology PRN members

with other professional organizations. An important accomplishment achieved by members of

the Nephrology PRN involved significant interactions with the National Kidney Foundation. Two

areas of focus were (1) achieving recognition of pharmacist involvement within NKF and (2)

gaining involvement in program planning and presentations at NKF meetings.

The Nephrology PRN members who joined NKF wished that the membership forms would

include “pharmacist” as a membership category choice. After a discussion with leaders within

the NKF, the selections were amended, and now, “Physician, Pharmacist, and Scientist” is a

membership category.

In addition, members of the Nephrology PRN were invited to create and deliver programming

for NKF meetings, with George Bailie serving as the first pharmacist representative on the NKF

annual program planning committee. Nephrology PRN members significantly involved in these

endeavors included George Bailie, Tom Comstock, Ed Foote, Darren Grabe, Alan Lau, Harold

Manley, Michael Marx, Nancy Mason, Gary Matzke, Bruce Mueller, and Wendy St. Peter.

Wendy St. Peter has also worked extensively with NKF, providing advice on Medicare Part D

since 2004, and is currently researching the perception of Medicare Part D by social workers

and dialysis patients. Involvement in NKF regional KEEP and CHERISH CKD screening

programs is an additional avenue of service for some PRN members, including Wendy St.

Peter.


June 2009

Reflective Statements

Nephrology is my area of practice and research and the PRN allows for communication

and the sharing of ideas among colleagues in nephrology and pharmacy.

–Mariann Churchwell

I am frequently asked how I got interested in kidney disease. The answer is easy.

Patients with kidney disease are a fascinating group of patients for a pharmacist.

Multiple medications, multiple comorbidities, a failing excretory organ, high risk of

medication misadventure. How could a pharmacist not be interested in these things?

Yet, I remain puzzled about why so few pharmacists have really embraced this area of

practice. Because the community of nephrology pharmacists is small, we must work that

much harder to help kidney patients and to help establish a firm position in patient care,

especially with CMS. I encourage the younger members of the group to continue their

work and to strive to spread their influence and expertise into the practice of community

pharmacy.

–Curt Johnson

The Nephrology PRN experience has enabled me to have a network of pharmacy

colleagues with similar clinical and/or research interests who are always there

consultation or advice. This was instrumental, particularly in the early phase of my

career, when it is often difficult to locate others with similar core interests.

–Melanie Joy

Being a part of the ACCP Nephrology PRN provides me a way of getting involved in

nephrology pharmacy, networking among fellow nephrology pharmacists and

contributing to the growth of clinical nephrology pharmacy. And most of all is getting to

know and working with nephrology pharmacy educators, leaderships, community and in

return give back to the profession and educate more future nephrology pharmacists.

–Tim Nguyen


June 2009

I’m a new practitioner working with patients with CKD. The Nephrology PRN has been a

great help to me as I’ve established my new practice site. The questions that come

across the listserv, the nephrology focus sessions at ACCP meetings, and, most

importantly, my interactions with fellow members at our PRN meetings have provided

valuable insight into pharmacotherapy issues in patients with CKD. I consider my

membership in the Nephrology PRN my most valued professional membership.

–Heather Nyman

The Nephrology PRN is an ideal venue to launch your career in nephrology whether it is

academia, clinical practice, or industry. The membership of the PRN is diverse and is

fortunate to have a well-maintained presence of individuals who have had a life-long

commitment to nephrology pharmacy practice. Interacting with the PRN early in my

career allowed me to interface with these individuals and opened up opportunities for

me that I don’t believe could have occurred elsewhere. Interacting with clinicians and

industry partners helps me stay “in the loop” of these practice areas.

–Amy Barton Pai

My roots were established in ACCP, and the Nephrology PRN has provided critical

nutrients to support my practice, research, and service in nephrology pharmacy. I can’t

overstate the value of having colleagues that I can use as a sounding board, step

forward when there is a critical need, recognize the need to advance CKD patient care

by conducting excellent practice and research, and understand the importance of public

advocacy. The Nephrology PRN contains the core group of people I know are as

passionate about nephrology pharmacy as I am.

–Wendy St. Peter

Teaching pharmacy students at my practice site at the dialysis unit at University of

California, Irvine, was the highlight of my nephrology-specific career. Members of the

Nephrology PRN were always available to assist me when questions arose. While no

longer “practicing” in nephrology, my heart remains with the Nephrology PRN. Members

of the Nephrology PRN gave me the opportunity to find my fellowship, the confidence to


June 2009

pursue academia, and a place to stay connected to the pulse of nephrology when my

career led me to drug development within the pharmaceutical industry. Mostly, I

appreciate the opportunities for leadership and service that the Nephrology PRN

provided.

–Ruth Ann Subach

The opportunity to network with a group of nephrology pharmacy specialists has

provided me with many opportunities including speaking at the ACCP meeting as well

as being a reviewer for the Nephrology PSAP modules. Most valuable in my daily

clinical practice is the Nephrology PRN list-serve, which provides access to a highly

trained group of people who can provide input into drug therapy practices in nephrology

– a specialty where RCTs may be either lacking or exclude our patients, so access to

these “opinions” becomes even more valuable.

–Lori Wazny

Vision for the Future

The Nephrology PRN has traditionally been one of the smaller networks within ACCP.

Nevertheless, members have worked untiringly to promote the acceptance of nephrology

pharmacists within all nephrology practice sites, including private and academic dialysis

centers. Although they are not fully described in this paper, Nephrology PRN members have

presented talks and abstracts at various national and international nephrology meetings,

including meetings for the American Nephrology Nurses Association, American Society of

Nephrology, Peritoneal Dialysis International, National Kidney Foundation, International

Society of Nephrology, and others. The Nephrology PRN continues to work with health care

providers including nurses, dieticians, and physicians of all levels of training in the care of

patients with acute and chronic kidney disease.

Future aims of the Nephrology PRN include:

• Expanding the active membership to 225 members by October 2010


June 2009

• Continued communication with and fostering of young pharmacy practitioners

• Enhancing the mentoring experiences for the early-career nephrology pharmacists

• Being known within ACCP and other organizations as the “go-to” people for assisting

others in caring for patients with any form of kidney disease, including providing

assistance in ensuring appropriate pharmacotherapy

• Increased visibility of nephrology pharmacists as independent investigators

• Centers for Medicare and Medicaid Services (CMS) recognition of pharmacists as

essential health care professionals to improve health and economic outcomes in and

their contribution to the care and well-being of patients with CKD

• Appointing members of the Nephrology PRN as liaisons to other PRNs to facilitate

collaboration and sharing of knowledge

• Advocating for the role of the pharmacist in the interdisciplinary health care team within

other nephrology organizations (e.g., ANNA, ASN, NKF, ISN)


June 2009

APPENDIX 1: Selected Nephrology PRN Abstracts and

Posters

ACCP Nephrology PRN: Past, present, future & you. ACCP Annual Meeting, Nashville, Tennessee,

August 1996.

Hudson JQ, Joy MS, Stamatakis MK, Walton T, Miller G, Smith C. Nephrology Practice and Research

Network Surveillance Study: anemia management in dialysis patients. Pharmacotherapy 2002;22:414.

ACCP Spring Meeting 2002. Poster Presentation – Savannah, Georgia.

Hudson JQ, Joy MS, Stamatakis MK, Walton T. Medication use and management of secondary

complications in a cohort of patients with ESRD. J Am Soc Nephrol 2002;13:674A.

Joy MS, Hudson JQ, Walton T, Stamatakis MK, Miller G, Smith C. Nephrology PRN surveillance study:

cardiovascular disease and treatment in dialysis patients. Pharmacotherapy 2002;22:415. ACCP Spring

Meeting. Poster Presentation – Savannah, Georgia, 2002.

Joy MS, Hudson JQ, Stamatakis MK, Walton T, Miller G, Smith C. Description of the Nephrology PRN

drug surveillance network program. Pharmacotherapy 2002;22:415. ACCP Spring Meeting. Poster

Presentation – Savannah, Georgia, 2002.

Stamatakis MK, Hudson JQ, Joy MS, Walton T, Miller G, Smith C. Treatment of hyperphosphatemia and

secondary hyperparathyroidism in patients undergoing dialysis: results from the Nephrology Drug

Surveillance Network. Pharmacotherapy 2002;22:414. ACCP Spring Meeting. Poster Presentation –

Savannah, Georgia, 2002.

Walton T, Joy MS, Stamatakis MK, Hudson JQ, Miller G, Smith C. Nephrology PRN drug surveillance

study: treatment of diabetes mellitus in dialysis patients. Pharmacotherapy 2002;22:414. ACCP Spring

Meeting. Poster Presentation – Savannah, Georgia, 2002.


June 2009

APPENDIX 2: Contributors

Primary Author and Coordinator:

Ruth Ann Subach, on behalf of the Nephrology PRN

Major Contributors:

ACCP Staff – digging into the history

George Bailie, Michael Bentley, Mariann Churchwell, Naomi Dahl, Renee

DeHart, Ed Foote, Darren Grabe, Joanna Hudson, Curtis Johnson, Melanie Joy,

Alan Lau, Harold Manley, Michael Marx, Nancy Mason, Gary Matzke, Bruce

Mueller, Timothy Nguyen, Heather Nyman, Amy Barton Pai, Katie Pallotta,

Wendy St. Peter, Michael Schwenk, Sarah Tomasello, Lori Wazny

october 2009

Documents

nephprn members

nephrology prn nephprn

accp staff

fellows of accp

educational programs

nephrology practice

initial members

degree programs