Title: Dose Adjustment in Renal Failure

Authors: Greeshma B Susan, Albert Thomas, Anjana Peter, Rosemary B Vadakkan, L Panayappan, Grace Thomas, K Krishnakumar

 DOI: https://dx.doi.org/10.18535/jmscr/v7i6.105

Abstract

The effect of a drug can be altered due to renal diseases. This is usually due to inefficient clearance of renally excreting drugs from the body. Pharmacokinetic parameters such as bioavailability, volume of distribution, protein binding, and biotransformation of a drug can also be altered in kidney diseases. Hence adjustment of dose according to renal clearance is important .Creatinine clearance is one of those parameters that help to assess the renal function. It can be estimated with Cockcroft- gault equation. Thus following proper dose adjustment for renally excreting drugs, wecan reduce the chances of drug induced nephrotoxicity.

References

  1. Myrna Y Munar, Harleen Singh. Drug dosing adjustments in patients with chronic kidney disease. Am Fam Physician .2007;75(10):1487-96
  2. Stephanie belaiche, Thierry Romanet, Robert Bell, Jean Calop, Benoit Allenet, Philippe Zaoui. Pharmaceutical care in chronic kidney disease: experience at Grenoble university hospital from 2006-2010 .JNNEPHROL.2012;25 (04):558-565
  3. Eric Decloedt, Rory Leisegang, Marc Blockman, Karen Cohen. Dosage Adjustment in medical patients with renal impairment at Groote Schuur hospital Cape town.SAMJ.2010; 100(5): 304-306.
  1. Tom N.Lea-Henry, Jane E Carland, Sophie L Stocker, Jacob Sevastos, Darren M Roberts. Clinical pharmacokinetics in kidney disease Fundamental principles. Nephropharmacology for the Clinician. 2018;13 : 1085-1095
  2. Ali J. Olyaei, Jessica L. Steffl .A Quantitative Approach to Drug Dosing in Chronic Kidney Disease .Blood purif. 2011; 31: 138-145
  3. Randall Faull. Prescribing in renal disease. Australian prescriber. 2007;30( 1): 17-20
  4. Leon shargel, Alan H Mutnick, Paul F Souney, Larry N Swanson. Compreh-ensive pharmacy Review of Naplex.8 th ed. Wolters Kluwer publishers;551-552
  5. Yahaya Hassan, Rowa J Al-Ramahi, Noorizan Abd Aziz, Rozina Ghazali. Impact of a renal drug dosing service on dose adjustment in hospitalized patients with chronic kidney disease. The Annals of pharmacotherapy. 2009; 43: 1598-1605.
  6. The renal drug handbook edited by Caroline Ashley and Aileen Currie. Third edition. Radcliffe publishers ;2009
  7. Lexi comp data

Corresponding Author

L Panayappan

Department of Pharmacy Practice, St James College of Pharmaceutical Sciences, Chalakudy

St James Hospital Trust Pharmaceutical Research Center (DSIR recognized), Chalakudy, Kerala