Drug dosing adjustments in patients with chronic kidney disease

Am Fam Physician. 2007 May 15;75(10):1487-96.

Abstract

Chronic kidney disease affects renal drug elimination and other pharmacokinetic processes involved in drug disposition (e.g., absorption, drug distribution, nonrenal clearance [metabolism]). Drug dosing errors are common in patients with renal impairment and can cause adverse effects and poor outcomes. Dosages of drugs cleared renally should be adjusted according to creatinine clearance or glomerular filtration rate and should be calculated using online or electronic calculators. Recommended methods for maintenance dosing adjustments are dose reductions, lengthening the dosing interval, or both. Physicians should be familiar with commonly used medications that require dosage adjustments. Resources are available to assist in dosing decisions for patients with chronic kidney disease.

Publication types

  • Review

MeSH terms

  • Biological Transport
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Drug Interactions
  • Drug Monitoring / methods*
  • Glomerular Filtration Rate
  • Humans
  • Kidney Failure, Chronic / drug therapy*
  • Kidney Failure, Chronic / metabolism*
  • Medication Errors / prevention & control
  • Pharmaceutical Preparations / administration & dosage*
  • Pharmaceutical Preparations / metabolism*
  • Physicians, Family / standards*
  • Practice Patterns, Physicians'

Substances

  • Pharmaceutical Preparations