Drugs in kidney diseases

Drugs in kidney diseases Shiva SeyrafianM.D. Nephrologist1391/2/30- - 19/5/2012

Drugs and the KidneyDrugs and the normal kidney Drugs toxic to the kidneyPrescribing in kidney diseaseCase presentation2Normal Kidney Function 1 Extra Cellular Fluid Volume control2 Electrolyte balance3 Waste product excretion4 Drug and hormone elimination/metabolism5 Blood pressure regulation6 Regulation of haematocrit7 regulation of calcium/phosphate balance(vitamin D3 metabolism)Pharmacokinetics

AbsorptionDistributionMetabolismElimination filtration secretionDrugs and normal kidney

Effects of renal disease on drugs

Patient related risk factors for drug-induced nephrotoxicityAbsolute or effective intravascular depletionAge older than 60 yearsDiabetes Exposure to multiple nephrotoxinsHeart failureSepsisUnderlying renal insufficiency (glumerular filtration rate