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Related Concept Videos

Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

128
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...
128
Factors Affecting Renal Clearance: Renal Impairment01:17

Factors Affecting Renal Clearance: Renal Impairment

127
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...
127
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

478
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
478
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

46
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
46
Renal Drug Excretion: Overview01:15

Renal Drug Excretion: Overview

213
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...
213
Renal Drug Clearance: Overview01:06

Renal Drug Clearance: Overview

264
Renal clearance is a crucial parameter in pharmacokinetics that quantifies the rate at which the kidneys excrete a drug. It represents a constant fraction of the central volume of distribution containing the drug that the kidney eliminates per unit of time.
Renal clearance can be calculated using different methods. One approach is to divide the urinary drug excretion rate by the plasma drug concentration. This method directly measures renal clearance, indicating the kidneys' efficiency in...
264

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Related Experiment Video

Updated: Aug 5, 2025

The Use of Reverse Phase Protein Arrays RPPA to Explore Protein Expression Variation within Individual Renal Cell Cancers
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Anticancer drug therapy for patients with renal dysfunction.

Koichi Suyama1, Yuji Miura2

  • 1Department of Medical Oncology, Toranomon Hospital, Tokyo, Japan. ksuyama@toranomon.gr.jp.

International Journal of Clinical Oncology
|March 28, 2023
PubMed
Summary

This review discusses anticancer drug administration in patients with renal dysfunction. It highlights the need for dose adjustments based on renal function and clinical experience due to limited evidence.

Keywords:
AgedGlomerular filtration rateImmune checkpoint inhibitorsKidney diseasesNeoplasmsUremic toxins

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Area of Science:

  • Oncology
  • Pharmacology
  • Nephrology

Background:

  • Cancer treatment rapidly evolves with targeted therapies and immunotherapies alongside conventional chemotherapy.
  • Clinicians face challenges administering chemotherapy to high-risk patients, including those with renal or liver dysfunction, on dialysis, or elderly.
  • Clear guidelines for anticancer drug use in renal dysfunction are lacking.

Purpose of the Study:

  • To review the administration of anticancer drugs in patients with renal dysfunction.
  • To provide insights into dose adjustments based on renal function and clinical experience.

Main Methods:

  • Literature review focusing on anticancer drug administration in renal impairment.
  • Analysis of existing data and clinical experience for dose recommendations.

Main Results:

  • No definitive evidence exists for anticancer drug administration in renal dysfunction.
  • Dose adjustments can be guided by understanding renal drug excretion and prior clinical data.

Conclusions:

  • Anticancer drug dosing in renal dysfunction requires careful consideration.
  • Further research is needed to establish clear evidence-based guidelines for safe and effective cancer treatment in renally impaired patients.