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Related Concept Videos

Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant01:25

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...
Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration01:28

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...
Renal Failure: Dose Adjustments01:11

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...
Drug Dosing in Renal Diseases: Measurement of Serum Creatinine Concentration and Clearance01:25

Drug Dosing in Renal Diseases: Measurement of Serum Creatinine Concentration and Clearance

In healthy individuals, serum creatinine levels remain stable due to a balance between its constant production—primarily from muscle metabolism—and renal excretion. Creatinine is freely filtered by the glomeruli, making it a valuable marker for estimating renal function. When the glomerular filtration rate (GFR) decreases, the kidneys can only eliminate less creatinine, causing serum levels to rise.Serum creatinine concentration is widely used to estimate creatinine clearance (Clcr), a...
Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate01:25

Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate

The glomerular filtration rate (GFR) is a critical indicator of kidney health, reflecting how well the kidneys filter blood. Changes in GFR can signal potential kidney impairment, necessitating accurate measurement methods to monitor kidney function effectively.Various molecules can serve as markers for GFR measurement, with the ideal marker meeting several specific criteria. It must freely filter at the glomerulus, avoid reabsorption or secretion by the renal tubules, remain unmetabolized, not...
Dosage Regimens: Designs and Approaches01:28

Dosage Regimens: Designs and Approaches

Designing a dosage regimen, which refers to the manner of drug administration, is a complex process involving the selection of drug dose, route, and frequency. This process is underpinned by pharmacokinetic parameters derived from tests and population averages. These parameters are then tailored to patient-specific variables such as diagnosis, demographics, and allergy status. Once therapy commences, therapeutic response monitoring is critical and achieved through clinical and physical...

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Related Experiment Video

Updated: Jun 13, 2026

Early Detection of Drug-Induced Renal Hemodynamic Dysfunction Using Sonographic Technology in Rats
06:38

Early Detection of Drug-Induced Renal Hemodynamic Dysfunction Using Sonographic Technology in Rats

Published on: March 11, 2016

Computerized decision support for medication dosing in renal insufficiency: a randomized, controlled trial.

Kevin M Terrell1, Anthony J Perkins, Siu L Hui

  • 1Indiana University Center for Aging Research, Indianapolis, IN, USA. kterrell@regenstrief.org

Annals of Emergency Medicine
|May 11, 2010
PubMed
Summary

Computerized physician order entry with decision support significantly reduced excessive medication dosing in patients with renal impairment. This electronic health record tool helps emergency physicians ensure safe medication practices for kidney disease patients.

Related Experiment Videos

Last Updated: Jun 13, 2026

Early Detection of Drug-Induced Renal Hemodynamic Dysfunction Using Sonographic Technology in Rats
06:38

Early Detection of Drug-Induced Renal Hemodynamic Dysfunction Using Sonographic Technology in Rats

Published on: March 11, 2016

Area of Science:

  • Clinical Pharmacology
  • Health Informatics
  • Nephrology

Background:

  • Emergency physicians frequently prescribe medications requiring renal dose adjustments.
  • Inappropriate dosing for renal impairment can lead to adverse events.
  • Computerized physician order entry (CPOE) systems offer potential for medication safety improvements.

Purpose of the Study:

  • To evaluate the effectiveness of CPOE decision support in reducing excessive medication dosing for patients with renal impairment in the emergency department.
  • To test the hypothesis that integrated dosing recommendations improve prescribing accuracy.

Main Methods:

  • A randomized controlled trial was conducted in an academic emergency department.
  • Physicians were randomized to use CPOE with (intervention) or without (control) decision support for discharge prescriptions.
  • Decision support provided renal-specific dosing recommendations based on estimated creatinine clearance.

Main Results:

  • Decision support was available for 2,783 patient visits (46% of total).
  • The intervention group (with decision support) had a significantly lower rate of excessive medication dosing (43%) compared to the control group (74%).
  • The effect size for reduced excessive dosing was 31% (95% CI 14% to 49%, P=.001).

Conclusions:

  • Emergency physicians commonly over-dose medications in patients with renal impairment.
  • CPOE systems with integrated decision support effectively reduce inappropriate medication dosing for patients with kidney disease.
  • This technology enhances medication safety in the emergency department setting.