Journal
CLINICAL PHARMACOLOGY & THERAPEUTICS
Volume 86, Issue 5, Pages 553-556Publisher
NATURE PUBLISHING GROUP
DOI: 10.1038/clpt.2009.163
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Chronic renal failure (CRF) has been shown, in animal models and clinical studies, to significantly reduce nonrenal clearance and to alter the bioavailability of predominantly metabolized drugs. Phase II reactions and drug transporters such as P-glycoprotein (P-gp) and organic anion transporting polypeptide (OATP) are also affected. High levels of parathyroid hormone (PTH), cytokines, and uremic toxins are implicated in some of these effects, which have a clinically significant impact on drug disposition and increase the risk of adverse drug reaction.
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