Effect of kidney disease on pharmacokinetics

Alterations in pharmacokinetics, which quantitatively describes the time course of drug disposition in the body, may lead to clinically significant changes in systemic exposure and corresponding response to drugs in patients with impaired kidney function, including those with acute and chronic kidney disease (CKD). Pharmacokinetic changes should be considered -when selecting and dosing medications in CKD patients to optimize the risk:benefit ratio. While changes in absorption, distribution, and renal clearance are well described for most drugs, changes in nonrenal clearance are less predictable. This chapter broadly reviews the effect of kidney disease on pharmacokinetics and presents strategies for drug dosing in patients with impaired kidney function.