What factors need to be considered when dosing patients on renal replacement therapies?

Source: South West Medicines Information and Training Area: Evidence > Medicines Q & A There are a number of factors that need to be considered when dosing patients on renal replacement therapy (RRT). Consider the drug, the patient and the type of RRT. Alteration of drug dosage is only necessary if renal clearance exceeds 25% of total body clearance. Drugs which are cleared by the kidneys are usually dialysed, and vice versa, although there are some anomalies. Dose adjustment for RRT is only necessary for drugs that require dose adjustment because of the presence of renal failure. No RRT is as effective as the normal kidney - so doses used will never be larger than those recommended in normal renal function. Pharmacokinetic studies that formed the basis for many of the drug dosing recommendations used today were performed in the 1980s and 1990s using less efficient techniques of RRT than those employed currently. These studies varied in design, used different haemofilters, blood, dialysate and ultrafiltration rate and calculated drug clearance by different ...
Source: NeLM - Medicines Q and A - Category: Drugs & Pharmacology Source Type: news