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FACTORS CONTRIBUTING TO VARIABILITY IN DRUG PHARMACOKINETICS. IV. RENAL EXCRETION
Author(s) -
Regårdh Carl G.
Publication year - 1985
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/j.1365-2710.1985.tb00932.x
Subject(s) - renal function , renal physiology , excretion , reabsorption , urine , kidney , pharmacokinetics , endocrinology , chemistry , medicine , extraction ratio , drug , pah clearance , dialysis , pharmacology , renal blood flow , effective renal plasma flow , chromatography , extraction (chemistry)
The renal excretion of drugs is mainly controlled by three factors: glomerular filtration, tubular secretion and tubular reabsorption. Only relatively polar drugs are excreted in appreciable amounts by the kidneys. Factors affecting renal excretion of drugs include: kidney function, protein binding, urine pH and urine flow. Impaired renal function may lead to a clinically significant accumulation of drugs eliminated by the kidneys, if more than 50% of the dose is normally excreted unchanged in the urine and the renal function is less than 50% of the normal value. Successful removal of a drug by dialysis requires that it possesses a polar character, low protein binding and a small to moderate volume of distribution.