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Acute Kidney Injury Pharmacokinetic Changes and Its Impact on Drug Prescription

Acute kidney injury (AKI) is a common problem in hospitalized patients that is associated with significant morbid-mortality. The impact of kidney disease on the excretion of drugs eliminated by glomerular filtration and tubular secretion is well established, as well as the requirement for drug dosag...

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Autores principales: Blanco, Victoria E., Hernandorena, Carolina V., Scibona, Paula, Belloso, Waldo, Musso, Carlos G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6473374/
https://www.ncbi.nlm.nih.gov/pubmed/30646533
http://dx.doi.org/10.3390/healthcare7010010
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author Blanco, Victoria E.
Hernandorena, Carolina V.
Scibona, Paula
Belloso, Waldo
Musso, Carlos G.
author_facet Blanco, Victoria E.
Hernandorena, Carolina V.
Scibona, Paula
Belloso, Waldo
Musso, Carlos G.
author_sort Blanco, Victoria E.
collection PubMed
description Acute kidney injury (AKI) is a common problem in hospitalized patients that is associated with significant morbid-mortality. The impact of kidney disease on the excretion of drugs eliminated by glomerular filtration and tubular secretion is well established, as well as the requirement for drug dosage adjustment in impaired kidney function patients. However, since impaired kidney function is associated with decreased activity of several hepatic and gastrointestinal drug-metabolizing enzymes and transporters, drugs doses adjustment only based on kidney alteration could be insufficient in AKI. In addition, there are significant pharmacokinetics changes in protein binding, serum amino acid levels, liver, kidney, and intestinal metabolism in AKI, thus the determination of plasma drug concentrations is a very useful tool for monitoring and dose adjustment in AKI patients. In conclusion, there are many pharmacokinetics changes that should be taken into account in order to perform appropriate drug prescriptions in AKI patients.
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spelling pubmed-64733742019-05-02 Acute Kidney Injury Pharmacokinetic Changes and Its Impact on Drug Prescription Blanco, Victoria E. Hernandorena, Carolina V. Scibona, Paula Belloso, Waldo Musso, Carlos G. Healthcare (Basel) Review Acute kidney injury (AKI) is a common problem in hospitalized patients that is associated with significant morbid-mortality. The impact of kidney disease on the excretion of drugs eliminated by glomerular filtration and tubular secretion is well established, as well as the requirement for drug dosage adjustment in impaired kidney function patients. However, since impaired kidney function is associated with decreased activity of several hepatic and gastrointestinal drug-metabolizing enzymes and transporters, drugs doses adjustment only based on kidney alteration could be insufficient in AKI. In addition, there are significant pharmacokinetics changes in protein binding, serum amino acid levels, liver, kidney, and intestinal metabolism in AKI, thus the determination of plasma drug concentrations is a very useful tool for monitoring and dose adjustment in AKI patients. In conclusion, there are many pharmacokinetics changes that should be taken into account in order to perform appropriate drug prescriptions in AKI patients. MDPI 2019-01-14 /pmc/articles/PMC6473374/ /pubmed/30646533 http://dx.doi.org/10.3390/healthcare7010010 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Blanco, Victoria E.
Hernandorena, Carolina V.
Scibona, Paula
Belloso, Waldo
Musso, Carlos G.
Acute Kidney Injury Pharmacokinetic Changes and Its Impact on Drug Prescription
title Acute Kidney Injury Pharmacokinetic Changes and Its Impact on Drug Prescription
title_full Acute Kidney Injury Pharmacokinetic Changes and Its Impact on Drug Prescription
title_fullStr Acute Kidney Injury Pharmacokinetic Changes and Its Impact on Drug Prescription
title_full_unstemmed Acute Kidney Injury Pharmacokinetic Changes and Its Impact on Drug Prescription
title_short Acute Kidney Injury Pharmacokinetic Changes and Its Impact on Drug Prescription
title_sort acute kidney injury pharmacokinetic changes and its impact on drug prescription
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6473374/
https://www.ncbi.nlm.nih.gov/pubmed/30646533
http://dx.doi.org/10.3390/healthcare7010010
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