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Drug administration in renal failure

J S Cheigh

    The American Journal of Medicine
    |April 1, 1977
    PubMed
    Summary

    Renal failure significantly impacts drug excretion and action, necessitating careful drug selection and dosing. This review offers practical guidelines for drug use in patients with kidney disease.

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    Area of Science:

    • Pharmacology
    • Nephrology
    • Clinical Therapeutics

    Background:

    • Renal failure alters drug pharmacokinetics, affecting excretion, protein binding, distribution, and biotransformation.
    • Dialysis introduces further complexity by modifying plasma-water-soluble drug levels.

    Purpose of the Study:

    • To summarize recent information on drug use in patients with impaired renal function.
    • To provide practical, evidence-based guidelines for drug selection and dosing in kidney disease.

    Main Methods:

    • Review of current literature on drug pharmacokinetics and pharmacodynamics in renal insufficiency.
    • Synthesis of available data to inform clinical practice.

    Main Results:

    • Renal insufficiency necessitates adjustments in the choice and dosage of numerous medications.
    • Limited but accumulating data guide drug management in kidney disease.

    Conclusions:

    • Drug management in renal failure requires careful consideration of altered physiological processes.
    • Guidelines are presented to aid clinicians in optimizing drug therapy for adult patients with kidney disease.

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