Pharmacokinetic effects of altered plasma protein binding of drugs in renal disease

摘要: The measurement of plasma drug concentrations provides no insight into the relationship between free and plasma-protein-bound fractions drugs. Plasma protein binding may decrease in renal disease due to uremia, hypoalbuminemia, or interactions. Decreased leads an increase fraction causing volume distribution a shorter elimination half life. apparent life cause total concentration. Therefore, concentration is more reliable than for therapeutic monitoring. However, amount tissue tissue-bound remain unchanged under steady state conditions. Thus, usually does not lead increased toxicity, alteration dosage required, although be found considerably lower normal. In addition binding, must also considered determination appropriate some drugs disease.