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Renal Failure: Dose Adjustments

Renal Failure: Dose Adjustments

In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
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...

Factors Affecting Renal Clearance: Renal Impairment

Factors Affecting Renal Clearance: Renal Impairment

Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...

Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant

Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant

In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...

Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment

Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment

Hepatic impairment, characterized by decreased liver function, does not uniformly mandate adjustments in drug dosage. Whether dosage modifications are necessary depends on various factors related to the drug's metabolism and elimination pathways. If a drug is primarily excreted via the kidneys and bypasses significant hepatic processing, if it undergoes minimal metabolic transformation in the liver, or if it is volatile and primarily expelled through the lungs, dose adjustments may not be...

Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration

Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration

Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area. This equation is...

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...

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Updated: Jul 10, 2026

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Erectile dysfunction in patients with chronic renal failure.

Leonardo E Messina¹, Joaquim A Claro, Archimedes Nardozza

¹Section of Urology, Paulista School of Medicine, Federal University of Sao Paulo, UNIFESP, Sao Paulo, SP, Brazil. leonardo@messina.med.br

International Braz J Urol : Official Journal of the Brazilian Society of Urology

|November 6, 2007

Summary

Erectile dysfunction affects over 60% of patients on hemodialysis, increasing with age and diabetes. This common condition in kidney disease patients often goes untreated.

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Treatment Model for Young Patients with Psychogenic Erectile Dysfunction and Resultant Infertility

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Assessment of Vascular Function in Patients With Chronic Kidney Disease

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Published on: June 16, 2014

Treatment Model for Young Patients with Psychogenic Erectile Dysfunction and Resultant Infertility

Treatment Model for Young Patients with Psychogenic Erectile Dysfunction and Resultant Infertility

Published on: May 30, 2025

Area of Science:

Nephrology
Urology
Andrology

Background:

Chronic kidney disease (CKD) significantly impacts patient quality of life.
Hemodialysis (HD) is a life-sustaining treatment for end-stage renal disease (ESRD).
Erectile dysfunction (ED) is a prevalent complication in patients with chronic conditions.

Purpose of the Study:

To determine the prevalence of erectile dysfunction (ED) in patients undergoing maintenance hemodialysis.
To investigate associations between ED and patient demographics, comorbidities, and dialysis parameters.

Main Methods:

A cross-sectional study involving 58 hemodialysis patients.
Assessment of ED using the International Index of Erectile Function (IIEF).
Analysis of demographic data, comorbidities, laboratory values, and medical history; statistical analysis using t-tests and chi-square tests.

Main Results:

The prevalence of ED was 60.3% among the studied hemodialysis patients.
ED prevalence increased with age, being higher in patients over 50.
A significant association was found between diabetes mellitus and ED; lower serum creatinine and Kt/V were observed in patients with ED.

Conclusions:

Erectile dysfunction is highly prevalent in hemodialysis patients.
Age, diabetes, and specific hemodialysis characteristics are linked to a higher incidence of ED.
A significant proportion of patients with ED did not seek medical attention.