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Related Concept Videos

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

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...
Factors Affecting Renal Clearance: Renal Impairment01:17

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: 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...
Acute Kidney Injury I: Introduction01:22

Acute Kidney Injury I: Introduction

Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
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...

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Related Experiment Video

Updated: Jun 8, 2026

Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Rate of kidney function decline associates with mortality.

Ziyad Al-Aly1, Angelique Zeringue, John Fu

  • 1Division of Nephrology, Saint Louis Veterans Affairs Medical Center, St. Louis, MO 63106, USA. zalaly@gmail.com

Journal of the American Society of Nephrology : JASN
|October 16, 2010
PubMed
Summary

The rate of kidney function decline significantly impacts mortality risk in patients with rheumatoid arthritis and chronic kidney disease (CKD). Faster decline indicates a higher risk of death, suggesting a dynamic approach to CKD definition.

Related Experiment Videos

Last Updated: Jun 8, 2026

Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Area of Science:

  • Nephrology
  • Rheumatology
  • Epidemiology

Background:

  • The relationship between kidney function decline rate and mortality in rheumatoid arthritis (RA) patients with early-stage chronic kidney disease (CKD) is not fully understood.
  • Existing definitions of CKD are static, potentially underestimating individual patient risk.

Purpose of the Study:

  • To investigate predictors of CKD progression in RA patients.
  • To determine the effect of the rate of kidney function decline on mortality risk.

Main Methods:

  • Retrospective cohort study of 4171 RA patients with stage 3 CKD using Veterans Affairs databases.
  • Longitudinal follow-up to assess CKD progression (estimated GFR decline) and mortality.
  • Statistical analysis to identify predictors and quantify mortality risk.

Main Results:

  • Severe CKD progression (>4 ml/min/yr decline) was associated with a 54% increased mortality risk (HR 1.54).
  • Moderate progression (1-4 ml/min/yr decline) showed a trend towards increased mortality (HR 1.10).
  • Peripheral artery disease, Black race, hypertension, diabetes, and cardiovascular disease predicted severe CKD progression.

Conclusions:

  • An independent, graded association exists between the rate of kidney function decline and mortality in RA patients with early CKD.
  • Incorporating the rate of decline into CKD definition can create a dynamic measure, improving risk assessment and patient management.