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Related Concept Videos

Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

343
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...
343
Factors Affecting Renal Clearance: Renal Impairment01:17

Factors Affecting Renal Clearance: Renal Impairment

335
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...
335
Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow01:26

Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow

145
Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug...
145
Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration01:28

Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration

106
Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area.
106
Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment01:08

Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment

116
Hepatic impairment, characterized by decreased liver function, does not uniformly mandate adjustments in drug dosage. Whether dosage modifications are necessary depends on various factors related to the drug's metabolism and elimination pathways. If a drug is primarily excreted via the kidneys and bypasses significant hepatic processing, if it undergoes minimal metabolic transformation in the liver, or if it is volatile and primarily expelled through the lungs, dose adjustments may not be...
116
Pharmacokinetics: Drug–Drug Interactions01:25

Pharmacokinetics: Drug–Drug Interactions

242
Drug interactions occur when the pharmacological effect of one drug is altered by another substance, either enhancing or diminishing its activity. The drug whose activity is altered is known as the object drug, and the substance causing the alteration is called the agent drug or the precipitant. The net effects of these interactions are mostly undesirable, leading to decreased effectiveness or increased adverse effects. In rare cases, interactions can be beneficial, such as the enhanced...
242

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Advancements in the Metabolic Profiling of Three-Dimensional Brain Tumor Spheroids for Drug Screening
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Fenofibrate-induced renal dysfunction, yes or no?

Fatemeh Emami1, Amirali Hariri1, Mohammad Matinfar2

  • 1Water and Electrolytes Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Journal of Research in Medical Sciences : the Official Journal of Isfahan University of Medical Sciences
|June 26, 2020
PubMed
Summary
This summary is machine-generated.

Fenofibrate (FEN) may protect kidneys in type 2 diabetes patients with hypertriglyceridemia. While FEN can increase creatinine, its discontinuation is not recommended due to potential renal protective effects.

Keywords:
Creatininefenofibraterenal dysfunction

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Area of Science:

  • Pharmacology
  • Nephrology
  • Endocrinology

Background:

  • Fenofibrate (FEN) is a fibrate drug used for hypertriglyceridemia and diabetic nephropathy in type 2 diabetes.
  • FEN is associated with increased serum creatinine levels as a potential side effect.

Purpose of the Study:

  • To evaluate the actual impact of fenofibrate therapy on renal function.
  • To synthesize findings from both experimental and clinical studies on fenofibrate's renal effects.

Main Methods:

  • Systematic review of literature using keywords 'fenofibrate,' 'renal,' and 'function.'
  • Databases searched included PubMed, Google Scholar, and Scopus.
  • Analysis of 45 collected articles (23 animal, 22 clinical studies).

Main Results:

  • Fenofibrate's protective mechanism appears linked to vascular endothelial functions.
  • Increased creatinine is potentially due to patient-specific sensitivities related to genetic polymorphism.
  • Monitoring serum creatinine is advised for patients with normal renal function on FEN, but discontinuation is not recommended.

Conclusions:

  • Fenofibrate may offer renal protection, particularly in diabetic patients with hypertriglyceridemia, mitigating diabetes-induced kidney injury.
  • The benefits of FEN in managing hypertriglyceridemia and protecting renal function outweigh the risks of transient creatinine elevation in most cases.
  • Further research into the genetic basis of FEN sensitivity could personalize treatment strategies.