A quantitative approach to drug dosing in chronic kidney disease.

摘要: Chronic kidney disease (CKD) is increasing at an alarming rate. Medication prescribing in this growing population especially difficult. Many pharmacological agents or their metabolites are eliminated unchanged through the kidney. Drug dosing CKD challenging as most patients have a number of comorbid conditions. Patients with take potential for drug interactions. Most also alterations to normal functioning different organs systems (e.g. heart, liver, gastrointestinal system) which affect pharmacokinetics commonly used drugs CKD. Pharmacokinetic behaviors highly variable In addition, management imprecise and requires estimating renal function, applying clinical judgment and, if available, therapeutic monitoring provide adequate pharmacotherapeutic concentrations optimize pharmacodynamic response while minimizing toxicities. For that removed system unchanged, modification should be considered according patient- drug-specific factors. Renal replacement therapy dialysis remove pharmacologic extensively, thus dose needed avoid failure. By quantitative approach, health care providers can improve outcomes reducing adverse reactions.