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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...

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

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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 Concentration

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Renal Failure: Dose Adjustments

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In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
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Updated: May 27, 2026

Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform

Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform

Published on: April 12, 2021

Optimizing renal replacement therapy in older adults: a framework for making individualized decisions.

Manjula Kurella Tamura¹, Jane C Tan, Ann M O'Hare

¹Division of Nephrology, Stanford University School of Medicine, Palo Alto, California 94304, USA. mktamura@stanford.edu

Kidney International

|November 18, 2011

Summary

Individualizing end-stage renal disease (ESRD) care for older adults requires balancing treatment risks, benefits, and patient preferences. This personalized approach may sometimes differ from standard clinical practice guidelines.

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Last Updated: May 27, 2026

Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform

Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform

Published on: April 12, 2021

Area of Science:

Nephrology
Geriatrics
Clinical Decision-Making

Background:

Older adults with end-stage renal disease (ESRD) often have comorbidities and lower life expectancy, complicating adherence to standard clinical guidelines.
Synthesizing risks and benefits of ESRD management strategies for this population is challenging due to differences from typical trial participants.

Purpose of the Study:

To present a framework for individualizing ESRD management decisions in older patients.
To guide clinicians in tailoring treatment recommendations based on patient-specific factors.

Main Methods:

Developed a framework considering life expectancy, risks/benefits of competing treatments, and patient preferences.
Applied the framework to key ESRD decisions: dialysis modality, vascular access, and transplantation referral.
Integrated quantitative benefit/harm data with qualitative patient preference assessments.

Main Results:

The framework supports personalized ESRD treatment decisions for older adults.
Individualized care may diverge from established practice guidelines in certain cases.
This approach enhances the quality of ESRD care by tailoring recommendations.

Conclusions:

A patient-centered framework is crucial for optimizing ESRD management in older populations.
Clinicians should consider individual factors beyond standard guidelines when making treatment recommendations.
Personalized ESRD care improves outcomes and quality of life for elderly patients.