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Related Concept Videos

Renal Failure: Dose Adjustments01:11

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

Factors Affecting Renal Clearance: Renal Impairment

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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...
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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

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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...
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Serum Studies: Renal Function Tests01:24

Serum Studies: Renal Function Tests

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Renal function tests are crucial for assessing kidney health, monitoring disease progression, and evaluating the kidneys' efficiency in waste elimination, fluid balance, and electrolyte regulation. These tests offer critical insights into kidney function, even though routine measurements may appear normal until there is a significant decline in the glomerular filtration rate or GFR. Typically, signs of kidney impairment only become evident when the GFR falls to about 50% of its normal level.
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Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate01:25

Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate

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

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

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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...
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The correct renal function evaluation in patients with thyroid dysfunction.

Mariadelina Simeoni1,2, Annamaria Cerantonio3, Ida Pastore4

  • 1Nephrology and Dialysis Unit, 'Magna Graecia' University, 88100, Catanzaro, CZ, Italy. adelina_simeoni@yahoo.it.

Journal of Endocrinological Investigation
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Summary

Thyroid dysfunction impacts kidney function. Estimated glomerular filtration rate (eGFR) is the most reliable measure for kidney function in these patients, while Cystatin C aids in assessing thyroid dysfunction severity.

Keywords:
CreatinineCystatin CRenal physiologyThyroid diseaseseGFR

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Area of Science:

  • Nephrology
  • Endocrinology
  • Clinical Chemistry

Background:

  • Thyroid dysfunction is linked to various kidney abnormalities affecting all nephron parts.
  • Dysthyroidism is a known risk factor for developing chronic kidney disease (CKD).
  • Both subclinical and overt thyroid disease correlate with altered creatinine, eGFR, measured GFR, and Cystatin C levels.

Purpose of the Study:

  • To systematically review studies on renal function evaluation in thyroid dysfunction patients.
  • To identify the most sensitive and specific parameter for assessing renal function in outpatients with thyroid dysfunction.

Main Methods:

  • Systematic review of relevant scientific literature.
  • Analysis of studies evaluating renal function parameters in patients with thyroid dysfunction.

Main Results:

  • Estimated glomerular filtration rate (eGFR), particularly using the CKD-EPI equation, is the most reliable and practical parameter for renal function assessment.
  • Cystatin C is more suitable for grading the severity of thyroid dysfunction.

Conclusions:

  • eGFR is the preferred method for monitoring kidney function in patients with thyroid disorders.
  • Cystatin C can serve as a valuable biomarker for assessing the degree of thyroid dysfunction.