Renal Drugs Info (from Wikipedia)
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In medicine, the clearance is a pharmacokinetic measurement of the renal excretion ability. Although clearance may also involve other organs than the kidney, it is almost synonymous with renal clearance or renal plasma clearance. Each substance has a specific clearance that depends on its filtration characteristics. Clearance is a function of glomerular filtration, secretion from the peritubular capillaries to the nephron, and reabsorption from the nephron back to the peritubular capillaries. Clearance is constant in first-order kinetics because a constant fraction of the drug is eliminated per unit time, but it is variable in zero-order kinetics, because the amount of drug eliminated per unit time changes with the concentration of drug in the blood. The concept of clearance was described by Thomas Addis, a graduate of the University of Edinburgh Medical School.
Kidney Disease
Kidney Disease is a chronic non-communicable disease, having serious consequence if it can not be controlled effectively. Generally, the process of Kidney Disease development is from light to serious. Most Kidney Diseases follow developing process of Renal Insufficiency, Renal Failure and Uremia.
Nephropathy, also known as kidney disease, means damage to or disease of a kidney. Nephrosis is non-inflammatory nephropathy. Nephritis is inflammatory kidney disease.
Causes
Causes of nephropathy include deposition of the IgA antibodies in the glomerulus, administration of analgesics, xanthine oxidase deficiency, toxicity of chemotherapy agents, and long-term exposure to lead or its salts. Chronic conditions that can produce nephropathy include systemic lupus erythematosus, diabetes mellitus and high blood pressure (hypertension), which lead to diabetic nephropathy and hypertensive nephropathy, respectively.
IgA nephropathy
Main article: IgA nephropathy
IgA nephropathy is the most common glomerulonephritis throughout the world Primary IgA nephropathy is characterized by deposition of the IgA antibody in the glomerulus. The classic presentation (in 40-50% of the cases) is episodic frank hematuria which usually starts within a day or two of a non-specific upper respiratory tract infection (hence synpharyngitic) as opposed to post-streptococcal glomerulonephritis which occurs some time (weeks) after initial infection. Less commonly gastrointestinal or urinary infection can be the inciting agent. All of these infections have in common the activation of mucosal defenses and hence IgA antibody production.
Analgesics
Main article: Analgesic nephropathy
One cause of nephropathy is the long term usage of analgesics. The pain medicines which can cause kidney problems include aspirin, acetaminophen, and nonsteroidal anti-inflammatory drugs, or NSAIDs. This form of nephropathy is "chronic analgesic nephritis," a chronic inflammatory change characterized by loss and atrophy of tubules and interstitial fibrosis and inflammation (BRS Pathology, 2nd edition).
Specifically, long term use of the analgesic phenacetin has been linked to renal papillary necrosis (necrotizing papillitis).
Xanthine oxidase deficiency
Main article: Xanthine oxidase deficiency
Another possible cause of nephropathy is due to decreased function of xanthine oxidase in the purine degradation pathway. Xanthine oxidase will degrade hypoxanthine to xanthine and then to uric acid. Xanthine is not very soluble in water; therefore, an increase in xanthine forms crystals (which can lead to kidney stones) and result in damage of the kidney. Xanthine oxidase inhibitors, like allopurinol, can cause nephropathy.
Polycystic Disease of the Kidneys
Main article: Polycystic kidney disease
Additional possible cause of nephropathy is due to the formation of cysts or pockets containing fluid within the kidneys. These cysts get enlarged with the progression of aging causing renal failure. Cysts may also form in other organs including the liver, brain and ovaries. Polycystic Kidney Disease is a genetic disease caused by mutations in the PKD1, PKD2, and PKHD1 genes. This disease affects about half a million people in the US. Polycystic kidneys are susceptible to infections and cancer.
Toxicity of Chemotherapy Agents
Main article: Onconephrology
Nephropathy can be associated with some therapies used to treat cancer. The most common form of kidney disease in cancer patients is Acute Kidney Injury (AKI) which can usually be due to volume depletion from vomiting and diarrhea that occur following chemotherapy or occasionally due to kidney toxicities of chemotherapeutic agents. Kidney failure from break down of cancer cells, usually after chemotherapy, is unique to onconephrology. Several chemotherapeutic agents, for example Cisplatin, are associated with acute and chronic kidney injuries. Newer agents such as anti Vascular Endothelial Growth Factor (anti VEGF) are also associated with similar injuries, as well as proteinuria, hypertension and thrombotic microangiopathy.
Renal Drugs Related Websites
Images for renal drugs
List of drugs used for Chronic Renal Failure ( Renal ... - Medindia
Renal Dosing Protocol Drug List (revised 8/04)
Renal Dosage Adjustment Protocol for Antimicrobials
Dosing Adjustment in Renal Dysfunction
Policy PH-02-15: Renal Dosing Program - University of Kentucky
Drug dosing in renal impairment - Shands Professionals
Drug dosing guidelines in patients with renal failure.
Antibiotic Dosing in Renal Impairment - University of Pennsylvania
Pharmacy Orientation - The University of Chicago Department of ...
Renal function - Food and Drug Administration
Dose Adjustments in Patients with Impaired Renal Function - ISAP
Medication Policies and Protocols - Welcome to ... - hcfms.com
Publications for Health Professionals - Kidney Health Australia
The Renal Drug Handbook - yimg.com
Kidney Disease of Diabetes - National Kidney and Urologic
Medicare Benefit Policy Manual, Chapter 11 - Centers for ...
Medications for treating hypertension - Harvard Health
Renal Dosing: Drug Prescribing in Renal Failure Nephrology: 3. Safe drug prescribing for patients with renal insufficiency (Click) Drug Dosing Adjustments in Patients with Chronic Kidney Disease (Click)
Drug-Induced Acute Renal Failure (Click) Guidelines for Drug Dosing Regimens in Chronic Kidney Disease (Click)
Drug Therapy in Kidney Disease (Click)
National Kidney Foundation (Click)
CREATININE CLEARANCE EQUATIONS
1) CKD-EPI CALCULATOR
2) mdcalc.com | MDRD GFR Equation
3) mdcalc.com | Creatinine Clearance (Cockcroft-Gault Equation)
Contrast Media and the Kidney
1) Contrast media and the kidney: European Society of Urogenital Radiology (ESUR) Guidelines
2) preventing iodinated contrast media induced renal failure - SFR
3) Guidelines on the Administration of Intravenous Iodinated Contrast
4) Manual on Contrast Media v8 - American College of Radiology
DailyMed Advanced Search Medicines Micromedex UpToDate
In medicine, the clearance is a pharmacokinetic measurement of the renal excretion ability. Although clearance may also involve other organs than the kidney, it is almost synonymous with renal clearance or renal plasma clearance. Each substance has a specific clearance that depends on its filtration characteristics. Clearance is a function of glomerular filtration, secretion from the peritubular capillaries to the nephron, and reabsorption from the nephron back to the peritubular capillaries. Clearance is constant in first-order kinetics because a constant fraction of the drug is eliminated per unit time, but it is variable in zero-order kinetics, because the amount of drug eliminated per unit time changes with the concentration of drug in the blood. The concept of clearance was described by Thomas Addis, a graduate of the University of Edinburgh Medical School.
Kidney Disease
Kidney Disease is a chronic non-communicable disease, having serious consequence if it can not be controlled effectively. Generally, the process of Kidney Disease development is from light to serious. Most Kidney Diseases follow developing process of Renal Insufficiency, Renal Failure and Uremia.
Nephropathy, also known as kidney disease, means damage to or disease of a kidney. Nephrosis is non-inflammatory nephropathy. Nephritis is inflammatory kidney disease.
Causes
Causes of nephropathy include deposition of the IgA antibodies in the glomerulus, administration of analgesics, xanthine oxidase deficiency, toxicity of chemotherapy agents, and long-term exposure to lead or its salts. Chronic conditions that can produce nephropathy include systemic lupus erythematosus, diabetes mellitus and high blood pressure (hypertension), which lead to diabetic nephropathy and hypertensive nephropathy, respectively.
IgA nephropathy
Main article: IgA nephropathy
IgA nephropathy is the most common glomerulonephritis throughout the world Primary IgA nephropathy is characterized by deposition of the IgA antibody in the glomerulus. The classic presentation (in 40-50% of the cases) is episodic frank hematuria which usually starts within a day or two of a non-specific upper respiratory tract infection (hence synpharyngitic) as opposed to post-streptococcal glomerulonephritis which occurs some time (weeks) after initial infection. Less commonly gastrointestinal or urinary infection can be the inciting agent. All of these infections have in common the activation of mucosal defenses and hence IgA antibody production.
Analgesics
Main article: Analgesic nephropathy
One cause of nephropathy is the long term usage of analgesics. The pain medicines which can cause kidney problems include aspirin, acetaminophen, and nonsteroidal anti-inflammatory drugs, or NSAIDs. This form of nephropathy is "chronic analgesic nephritis," a chronic inflammatory change characterized by loss and atrophy of tubules and interstitial fibrosis and inflammation (BRS Pathology, 2nd edition).
Specifically, long term use of the analgesic phenacetin has been linked to renal papillary necrosis (necrotizing papillitis).
Xanthine oxidase deficiency
Main article: Xanthine oxidase deficiency
Another possible cause of nephropathy is due to decreased function of xanthine oxidase in the purine degradation pathway. Xanthine oxidase will degrade hypoxanthine to xanthine and then to uric acid. Xanthine is not very soluble in water; therefore, an increase in xanthine forms crystals (which can lead to kidney stones) and result in damage of the kidney. Xanthine oxidase inhibitors, like allopurinol, can cause nephropathy.
Polycystic Disease of the Kidneys
Main article: Polycystic kidney disease
Additional possible cause of nephropathy is due to the formation of cysts or pockets containing fluid within the kidneys. These cysts get enlarged with the progression of aging causing renal failure. Cysts may also form in other organs including the liver, brain and ovaries. Polycystic Kidney Disease is a genetic disease caused by mutations in the PKD1, PKD2, and PKHD1 genes. This disease affects about half a million people in the US. Polycystic kidneys are susceptible to infections and cancer.
Toxicity of Chemotherapy Agents
Main article: Onconephrology
Nephropathy can be associated with some therapies used to treat cancer. The most common form of kidney disease in cancer patients is Acute Kidney Injury (AKI) which can usually be due to volume depletion from vomiting and diarrhea that occur following chemotherapy or occasionally due to kidney toxicities of chemotherapeutic agents. Kidney failure from break down of cancer cells, usually after chemotherapy, is unique to onconephrology. Several chemotherapeutic agents, for example Cisplatin, are associated with acute and chronic kidney injuries. Newer agents such as anti Vascular Endothelial Growth Factor (anti VEGF) are also associated with similar injuries, as well as proteinuria, hypertension and thrombotic microangiopathy.
Renal Drugs Related Websites
Images for renal drugs
List of drugs used for Chronic Renal Failure ( Renal ... - Medindia
Renal Dosing Protocol Drug List (revised 8/04)
Renal Dosage Adjustment Protocol for Antimicrobials
Dosing Adjustment in Renal Dysfunction
Policy PH-02-15: Renal Dosing Program - University of Kentucky
Drug dosing in renal impairment - Shands Professionals
Drug dosing guidelines in patients with renal failure.
Antibiotic Dosing in Renal Impairment - University of Pennsylvania
Pharmacy Orientation - The University of Chicago Department of ...
Renal function - Food and Drug Administration
Dose Adjustments in Patients with Impaired Renal Function - ISAP
Medication Policies and Protocols - Welcome to ... - hcfms.com
Publications for Health Professionals - Kidney Health Australia
The Renal Drug Handbook - yimg.com
Kidney Disease of Diabetes - National Kidney and Urologic
Medicare Benefit Policy Manual, Chapter 11 - Centers for ...
Medications for treating hypertension - Harvard Health
Renal Dosing: Drug Prescribing in Renal Failure Nephrology: 3. Safe drug prescribing for patients with renal insufficiency (Click) Drug Dosing Adjustments in Patients with Chronic Kidney Disease (Click)
Drug-Induced Acute Renal Failure (Click) Guidelines for Drug Dosing Regimens in Chronic Kidney Disease (Click)
Drug Therapy in Kidney Disease (Click)
National Kidney Foundation (Click)
CREATININE CLEARANCE EQUATIONS
1) CKD-EPI CALCULATOR
2) mdcalc.com | MDRD GFR Equation
3) mdcalc.com | Creatinine Clearance (Cockcroft-Gault Equation)
Contrast Media and the Kidney
1) Contrast media and the kidney: European Society of Urogenital Radiology (ESUR) Guidelines
2) preventing iodinated contrast media induced renal failure - SFR
3) Guidelines on the Administration of Intravenous Iodinated Contrast
4) Manual on Contrast Media v8 - American College of Radiology
