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Published on: March 11, 2016
Early research on renal function and drug action
1Weill Cornell Medical College, 1300 York Ave LC-423, New York, NY 10065, USA. mmreid@med.cornell.edu
Journal of Clinical Pharmacology
|January 11, 2012
Summary
Systematic studies reveal significant differences in drug action for patients with renal failure. Understanding these pharmacokinetic changes improves drug predictability, making therapy safer and more effective for azotemic patients.
Area of Science:
- Pharmacology
- Nephrology
- Drug Metabolism
Background:
- Systematic studies on drug action in renal failure began in the 1960s.
- Impaired drug excretion, linked to glomerular filtration rate, was recognized earlier.
- Early work by Kunin in 1967 tabulated antimicrobial pharmacokinetics for azotemic patients.
Purpose of the Study:
- To review the known effects of renal failure on drug action.
- To highlight how understanding these effects improves drug therapy predictability.
- To emphasize the enhanced safety and efficacy of drug treatment in azotemic individuals.
Main Methods:
- Review of systematic studies on drug action in renal failure.
- Analysis of pharmacokinetic data, including drug excretion and metabolism.
- Examination of changes in drug distribution, protein binding, and sensitivity.
Main Results:
- Renal failure significantly alters drug pharmacokinetics compared to healthy individuals.
- Changes observed include altered drug metabolism pathways and modified drug distribution.
- Drug-protein binding and drug sensitivity can also be affected by renal impairment.
Conclusions:
- Knowledge of renal failure's impact on drug action enhances predictability.
- This predictability leads to safer and more effective drug therapy for azotemic patients.
- Understanding pharmacokinetic alterations is crucial for optimizing medication in kidney disease.
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