The kidney is an important organ in regulating body fluids, electrolyte balance, removal of metabolic waste, and drug excretion from the body. Impairment or degeneration of kidney function affects the pharmacokinetics of drugs. Some of the more common causes of kidney failure include disease, injury, and drug intoxication. lists some of the conditions that may lead to chronic or acute renal failure. Acute diseases or trauma to the kidney can cause uremia, in which glomerular filtration is impaired or reduced, leading to accumulation of excessive fluid and blood nitrogenous products in the body. Uremia generally reduces glomerular filtration and/or active secretion, which leads to a decrease in renal drug excretion resulting in a longer elimination half-life of the administered drug.
This topic describes: a. Renal impairment b. Pharmacokinetic considerations c. General approach for dosage adjustment in Renal disease. d. Measurement of Glomerular Filtration rate and creatinine clearance. e. Dosage adjustment for uremic patients. f. Extracorporeal removal of drugs. g. Effect of Hepatic disease on pharmacokinetics.