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Therapy of hyperhomocysteinemia in chronic kidney disease
1Division of Clinical Pharmacology, Amiens University Hospital, Amiens, France. massy@u-picardie.fr
Abstract:
Recent published evidence suggests that the correction of the multiple remethylation pathway abnormalities in chronic kidney disease (CKD), beyond folate-related disturbances, enhanced removal of uremic toxins and/or homocysteine (Hcy), and maneuvers aimed to displace Hcy from protein-binding sites, may represent valuable strategies to normalize total Hcy concentrations in CKD patients. The relevance of decreasing Hcy levels for cardiovascular disease in CKD patients should be shown definitively by the results of ongoing randomized trials.
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Renal Failure: Dose Adjustments
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
