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Related Concept Videos

Dialysis01:27

Dialysis

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Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
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Dialysis01:15

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Dialysis is a diffusion-based purification process that separates analyte molecules from a complex matrix. This is accomplished by allowing molecules in the solution to pass through a semipermeable membrane into a liquid on the other side. The membrane is usually made of cellulose acetate or cellulose nitrate, and the second liquid must be miscible with the solution. Ions (e.g., chloride or sodium) or organic molecules (e.g., glucose) can pass through the membrane pores, which generally have...
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Hemodialysis III: Nursing Management01:25

Hemodialysis III: Nursing Management

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The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this...
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Chronic Kidney Disease III: Interprofessional Care01:28

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Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
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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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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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Related Experiment Video

Updated: Mar 23, 2026

Surgical Techniques for Catheter Placement and 5/6 Nephrectomy in Murine Models of Peritoneal Dialysis
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Prescribing for patients on dialysis.

Brendan Smyth1, Ceridwen Jones1, John Saunders1

  • 1Royal Prince Alfred Hospital, Sydney.

Australian Prescriber
|April 5, 2016
PubMed
Summary

Drug pharmacokinetics change in dialysis patients. Dose adjustments, considering drug clearance and therapeutic index, are often necessary. Consult specialists before prescribing and start with low doses.

Area of Science:

  • Pharmacology
  • Nephrology
  • Clinical Pharmacy

Background:

  • Renal impairment significantly alters drug pharmacokinetics.
  • Dialysis introduces further complexity to drug elimination.
  • Prescribing for patients on dialysis requires careful consideration of drug properties.

Purpose of the Study:

  • To highlight the pharmacokinetic changes of drugs in patients undergoing dialysis.
  • To provide guidance on dose adjustments for renally impaired patients requiring dialysis.
  • To emphasize the importance of consulting resources before drug prescription.

Main Methods:

  • Review of pharmacokinetic principles in renal impairment.
  • Analysis of factors influencing drug clearance during dialysis.
Keywords:
haemodialysiskidneypharmacokineticsrenal disease

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  • Identification of contraindications and necessary dose modifications.

    • Main Results:

    • Drug pharmacokinetics are frequently altered in patients with renal impairment on dialysis.
    • Some medications are contraindicated in this patient population.
    • Dose adjustments, including lower doses or less frequent administration, are often required based on drug clearance and therapeutic index.

    Conclusions:

    • Careful drug selection and dose management are crucial for patients on dialysis.
    • Consultation with nephrologists or drug reference sources is recommended prior to prescribing.
    • Initiating therapy with a low dose and titrating gradually, with post-dialysis administration for once-daily drugs, is advised.