Drug Use in Hemodialysis Patients
All Aspects of Hemodialysis, NOVA Publications , ss.447-457, 2025
- Yayın Türü: Kitapta Bölüm / Araştırma Kitabı
- Basım Tarihi: 2025
- Yayınevi: NOVA Publications
- Sayfa Sayıları: ss.447-457
- Anahtar Kelimeler: chronic kidney disease, drug, haemodialysis, pharmacodynamics, pharmacokinetics
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Medicines play an important role in the treatment of patients with kidney disease. When used appropriately, medicines can slow the progression of kidney disease and reduce morbidity and mortality. Renal function affects the pharmacokinetics and pharmacodynamics of at least 50% of medicines. In renal dysfunction, not only renal excretion but also drug bioavailability and absorption, protein binding and metabolism may be altered. These changes may expose the patient to an over- or underdose of the drug, resulting in dose-related drug toxicity or therapeutic failure. Effective and safe drug use is difficult in patients with chronic kidney disease and especially in dialysis patients. The dose and/or dose intervals of the drugs used in this patient group should be adjusted according to creatinine clearance. Some medicines have a nephrotoxic effect and may cause further deterioration in kidney function. Since certain drugs are removed by dialysis, dose adjustment or additional doses may be required. In addition to renal failure, polypharmacy also develops with the treatment of comorbid conditions. Therefore, drugdrug interactions and the frequency of side effects may increase. Knowing the degree of chronic kidney disease and the general pharmacokinetic and distribution properties of the drug allows individualised treatment modalities to be established. Thus, the drug is used at therapeutic level and patients are protected from serious side effects. In this chapter, we aimed to outline the basic principles of drug use in chronic kidney disease, especially in dialysis patients.