Drug dosing in chronic kidney disease

Patients with chronic kidney disease (CKD) are at high risk for adverse drug reactions and drug-drug interactions. Renal dysfunction-induced changes in human pathophysiology regularly results in altered pharmacodynamics and medication handling of a number of pharmacologic agents. This article reviews these observed changes and discusses strategies for appropriate drug dosing in patients with renal insufficiency. Specific recommendations for drug dosing in CKD are also included for the following classes of medications: anticoagulants, antihypertensives, cardiac medications, hypoglycemics, analgesics, antimicrobials, and miscellaneous agents.