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Chronic Kidney Disease

 Renal adjustments in CKD and AKI 

😏 Acute kidney injury is not very cute ⁠

💧 Most drugs, particularly water-soluble drugs and their metabolites, are eliminated largely by the kidneys in urine. ⁠

⭐️ It is important to know which drugs require dose adjustments to prevent accumulation and toxicity in patients with chronic kidney disease (CKD) as well as those with acute kidney injury. ⁠

🤔 Things to keep in mind when renally adjusting medications: ⁠

👉🏻 Use estimated GFR or CrCl to determine drug dosing⁠
👉🏻 If the patient is on hemodialysis, the type of HD will also determine drug dosing⁠
👉🏻 CrCl should be monitored periodically in patients with AKI to determine if doses need to be adjusted when CrCl improves⁠
👉🏻 Some medications require individualized therapy (ex: serum drug level monitoring, vital signs, adverse effects) when dose adjusting⁠