THOMAS C. DOWLING DRUG METAB LISM IN CHRONIC KIDNEY DISEASE Drug Metabolism Considerations in Patients With Chronic Kidney Disease
نویسنده
چکیده
Chronic kidney disease (CKD) is a progressive process leading to end stage renal disease and either dialysis or transplantation. Patients with CKD often have numerous comorbid conditions such as diabetes, hypertension, and acid-base and electrolyte disorders that can lead to alterations in homeostasis. Changes in drug disposition including hepatic metabolism via phase 1 (ie, cytochrome P-450 enzymes) and phase 2 (ie, conjugation) pathways have been reported. Biotransformation of drugs and endogenous substances within the kidney itself may also be compromised in the presence of CKD. Reduced hepatic and renal clearance leads to systemic accumulation of the parent drug as well as active and toxic metabolites. Characterization of specific hepatic cytochrome (CYP) enzyme pathways in patients with CKD is an area of current research and will lead to an understanding of phenotypic and genotypic expression patterns of several key drug-metabolizing enzymes. The evolving knowledge of CYP enzymes and the alterations that can occur in CKD should allow clinicians to predict adverse consequences of drug therapy and thus prevent these events from occurring. The pharmacy practitioner can also provide important pharmacotherapy interventions in this special patient population, including dose individualization, therapeutic drug monitoring, and evaluation of therapeutic outcomes.
منابع مشابه
Chronic Kidney Diseases, Metabolic Syndrome and Crp Level in The Elderly Residents of Kahrizak Charity Foundation
Objectives: In this study, we investigated the inter-relationships between C-reactive protein, metabolic syndrome, and chronic kidney disease among a group of Iranian elderly. Methods & Materials: In this cross-sectional study, 122 elderly among 1220 aged residents of Kahrizak Charity foundation with average age of 73.6±9.71 were studied. Metabolic syndrome and chronic kidney diseasewere def...
متن کاملSeroprevalence of Hepatitis B and C Virus Infection in Children with Chronic Kidney Diseases; A Historical Cohort Study
Background: The prevalence of hepatitis B and C in Iranian children with chronic kidney disease is limited. Therefore, the present study intends to assess the prevalence of hepatitis B and C in children with chronic kidney disease (CKD).Method: The present study is a historical cohort study which was conducted in a window period of 25 years in Children’s Medical Center in Tehran, 1991-2016. Dat...
متن کاملClean Revised version TXT Submitted to Expert Opinion on Drug Metabolism & Toxicology Pharmacokinetic considerations for the treatment of diabetes in patients with chronic kidney disease
متن کامل
Etiology and Outcome of Chronic Kidney Disease in Iranian Children
Background Considering the significant geographical and ethnical differences in pattern of incidence, etiology and outcome of chronic kidney disease (CKD), the present study aimed to assess the etiology and outcome of CKD in Iranian children. Materials and Methods In a cross-sectional study etiology and outcome of 372 children aged 3 months to 18 years with CKD was studied during the period 199...
متن کاملEndocrine disorders in chronic kidney disease
Background and Objective: Endocrine disorders are common in patients with chronic kidney disease (CKD). The aim of the present study is reviewing available literature to give a deep understanding of complexities of endocrine disorders in chronic kidney disease. Methods: A narrative reviewing method based on the available literature was approached. Findings: Generally, when renal function de...
متن کامل