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Related Concept Videos

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...
154
Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

151
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...
151
Factors Affecting Renal Clearance: Drug Distribution and Drug Interactions01:09

Factors Affecting Renal Clearance: Drug Distribution and Drug Interactions

223
Renal clearance plays a pivotal role in drug elimination from the body and can be influenced by drug distribution and interactions. Understanding these factors is crucial in pharmacology as they impact the effectiveness and duration of drug therapy.
One important factor is the relationship between renal clearance and the apparent volume of distribution. Renal clearance tends to be inversely proportional to the apparent volume of distribution. Drugs with an extensive distribution volume or those...
223
Renal Drug Clearance: Comparison Between Renal Excretion Methods01:08

Renal Drug Clearance: Comparison Between Renal Excretion Methods

267
Renal clearance is a critical parameter encompassing kidney filtration, secretion, and reabsorption processes. It is calculated using a specific equation to determine the rate at which the kidneys clear a drug.
Renal clearance is often associated with the renal glomerular filtration rate (GFR), which represents the rate at which plasma is filtered through the glomeruli in the kidney. When drug reabsorption is minimal and there is no active secretion, renal clearance is closely related to the...
267
Renal Drug Clearance: Overview01:06

Renal Drug Clearance: Overview

321
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...
321
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

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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...
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Updated: Sep 9, 2025

Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform
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Creatinine clearance, reduced kidney function, and optimizing prescribing safety through practice feedback: a mixed

Su I Wood1, Robbie Foy1, Paul Carder2

  • 1Division of Primary Care, Palliative Care and Public Health, Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9LN, United Kingdom.

Family Practice
|September 5, 2025
PubMed
Summary
This summary is machine-generated.

Performance feedback improved creatinine clearance (CrCl) calculation and coding in older adults, but further system support is needed to reduce medication errors in reduced kidney function.

Keywords:
feasibility studiesgeneral practicelongitudinal studiesprescribingqualitative researchquality and safety

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Area of Science:

  • Geriatric Medicine
  • Clinical Pharmacy
  • Health Services Research

Background:

  • Kidney function naturally declines with age, elevating the risk of adverse drug events due to higher medication levels.
  • Inappropriate prescribing is common in elderly patients with diminished creatinine clearance (CrCl).

Purpose of the Study:

  • To assess the feasibility and acceptability of performance feedback interventions.
  • To enhance CrCl calculation and coding practices.
  • To reduce potentially inappropriate prescribing in older adults.

Main Methods:

  • A mixed-methods study involving evidence-based performance feedback on CrCl coding and prescribing in seven UK general practices.
  • Data collection at three time points, with pre-/post-intervention assessments.
  • Institutional ethnography including observations and semi-structured interviews with primary care clinicians.

Main Results:

  • Mean CrCl coding for patients aged 75 and over increased from 46% to 50.4%.
  • A reduction in the number of patients with CrCl-associated inappropriate prescribing was observed.
  • Clinicians found feedback engaging and flexible, though challenges in CrCl calculation and medication recall persisted.

Conclusions:

  • Performance feedback can drive improvements in prescribing for reduced kidney function but requires supplementary support.
  • Systematized CrCl calculation and coding are crucial for enhancing patient safety through improved decision support.
  • A large-scale effectiveness evaluation is deemed feasible and acceptable.