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Related Concept Videos

Drug Elimination by Renal Route: Glomerular Filtration01:17

Drug Elimination by Renal Route: Glomerular Filtration

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The kidney serves as the primary organ responsible for eliminating drugs and their metabolites from the body. This process, known as renal elimination, starts with glomerular filtration and results in urine formation. Each kidney houses millions of functional units called nephrons, where urine production takes place. A nephron has two main components: a renal corpuscle and a renal tubule. Drugs gain access to the kidney via the renal artery, which progressively branches off into afferent...
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Renal Drug Excretion: Overview01:15

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As primary excretory organs, the kidneys maintain homeostasis by removing waste substances from the bloodstream. They comprise over a million units called nephrons, which serve as the kidney's functional units.
A nephron consists of two primary structures: the renal corpuscle and the renal tubule. The renal corpuscle contains the glomerulus, a network of capillaries where the first step of renal excretion, glomerular filtration, occurs. Blood pressure forces water, ions, and small molecules...
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Renal Drug Excretion: Tubular Reabsorption01:25

Renal Drug Excretion: Tubular Reabsorption

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Tubular reabsorption, a process occurring post-glomerular filtration of drugs in the renal tubule, is a critical determinant of drug half-life. During the process of renal excretion, as the glomerular filtrate progresses to the distal convoluted tubule (DCT), drugs that are highly permeable, lipophilic, and nonionized undergo passive reabsorption from the tubular fluid into the surrounding peritubular capillaries. This reabsorption process restricts their elimination through the kidneys. This...
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Drug Elimination by Renal Route: Tubular Reabsorption01:22

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During the process of renal excretion, as the glomerular filtrate progresses to the distal convoluted tubule (DCT), drugs that are highly permeable, lipophilic, and nonionized undergo passive reabsorption from the tubular fluid into the surrounding peritubular capillaries. This reabsorption process restricts their elimination through the kidneys. However, the majority of drugs are either weak acids or weak bases, and their ionization level is dependent on pH. By altering the pH of urine, the...
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Renal Drug Excretion: Glomerular Filtration01:02

Renal Drug Excretion: Glomerular Filtration

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The kidney serves as the primary organ responsible for eliminating drugs and their metabolites from the body. This process, known as renal elimination, starts with glomerular filtration and results in urine formation. Each kidney houses millions of functional units called nephrons, where urine production occurs. A nephron has two main components: a renal corpuscle and a renal tubule.
Drugs gain access to the kidney via the renal artery, which progressively branches off into afferent arterioles....
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Drug Elimination by Renal Route: Tubular Secretion01:15

Drug Elimination by Renal Route: Tubular Secretion

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Once the process of glomerular filtration is completed, blood carrying unfiltered drug molecules traverses through efferent arterioles and makes its way into the peritubular capillaries in the proximal tubule. A variety of carriers play a pivotal role in actively secreting drugs from these peritubular capillaries into the tubular fluid. The organic anion transporter transfers acidic drugs, against an electrochemical gradient, from the peritubular capillaries into the renal tubule cells and...
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Updated: Apr 5, 2026

Direct Drug Delivery to Kidney via the Renal Artery
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Drugs and the kidney.

S Naidoo1, A M Meyers

  • 1School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand; Charlotte Maxeke Johannesburg Academic Hospital; and Wits Donald Gordon Medical Centre, Johannesburg, South Africa. sagrennaidoos@yahoo.com.

South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde
|August 22, 2015
PubMed
Summary

Many drugs can harm the kidneys, especially in older adults with reduced kidney function. Early diagnosis and awareness of drug nephrotoxicity are crucial for proper management and prevention of chronic kidney disease (CKD).

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Area of Science:

  • Nephrology
  • Pharmacology
  • Internal Medicine

Background:

  • Drug-induced nephrotoxicity is a significant clinical concern, particularly in patients with diminished renal function.
  • Reduced glomerular filtration rate (GFR), common in aging populations, exacerbates renal side effects of medications.
  • Understanding drug pharmacokinetics and renal excretion is vital for preventing kidney damage.

Purpose of the Study:

  • To provide a comprehensive overview of drug nephrotoxicity, emphasizing prevention and early diagnosis.
  • To highlight specific drug classes and agents associated with renal adverse effects.
  • To inform clinical practice regarding safe medication use in patients with varying degrees of kidney function.

Main Methods:

  • Review of existing literature on drug nephrotoxicity and renal side effects.
  • Analysis of mechanisms by which therapeutic agents can induce kidney damage.
  • Discussion of clinical implications and management strategies for drug-induced kidney injury.

Main Results:

  • Numerous therapeutic agents pose a risk of nephrotoxicity, particularly when renal excretion is impaired.
  • Conditions like chronic kidney disease (CKD) stages 2-5 increase susceptibility to drug-induced renal damage.
  • Specific examples include NSAIDs worsening hypertension, aspirin increasing bleeding risk, and ACE inhibitors/ARBs causing electrolyte imbalances.

Conclusions:

  • Awareness of drug nephrotoxicity is essential for appropriate medication selection and dosing, especially in elderly patients and those with CKD.
  • Certain drugs like digoxin are contraindicated in specific CKD stages, while others like topiramate can cause kidney stones.
  • Careful use of radiocontrast media and gadolinium-based agents is recommended in patients with advanced CKD to prevent further renal injury.