RT Book, Section A1 Shargel, Leon A1 Wu-Pong, Susanna A1 Yu, Andrew B.C. SR Print(0) ID 56607716 T1 Chapter 21. Dose Adjustment in Renal and Hepatic Disease T2 Applied Biopharmaceutics & Pharmacokinetics, 6e YR 2012 FD 2012 PB The McGraw-Hill Companies PP New York, NY SN 978-0-07-160393-5 LK accesspharmacy.mhmedical.com/content.aspx?aid=56607716 RD 2024/03/29 AB Chronic kidney disease (CKD) is a worldwide public health problem affecting more than 50 million people, and more than 1 million of them are receiving kidney replacement therapy (Levey et al, 2009). The kidney is an important organ in regulating body fluids, electrolyte balance, removal of metabolic waste, and drug excretion from the body. Impairment or degeneration of kidney function affects the pharmacokinetics of drugs. Some of the more common causes of kidney failure include disease, injury, and drug intoxication. Table 21-1 lists some of the conditions that may lead to chronic or acute renal failure. Acute diseases or trauma to the kidney can cause uremia, in which glomerular filtration is impaired or reduced, leading to accumulation of excessive fluid and blood nitrogenous products in the body. Uremia generally reduces glomerular filtration and/or active secretion, which leads to a decrease in renal drug excretion resulting in a longer elimination half-life of the administered drug.