Farmacoterapia en la Enfermedad Renal

Abstract

¹Fundamental Nursing and Medical-Surgical Department. Faculty of Health Sciences. University of Barcelona. Barcelona. Spain One of the pillars of the treatment of people with kidney disease is the administration of drugs that provide elements inadequately metabolized by the kidney or minimize other complications of the disease^1,2. Many commonly used drugs are metabolized or eliminated by the kidney, but their pharmacokinetics and in some cases sensitivity to them is altered by the disease; there are changes in the absorption, distribution and metabolism of drugs and also in their excretion that modify the level reached at normal doses, potentially changing their effectiveness and increasing the probability of accumulation and adverse effects, including renal toxicity^1-3. On the other hand, there are drugs used for frequent ailments which, regardless of whether or not they require dose adjustment, are nephrotoxic and can affect renal function, with significant being non-steroidal anti-inflammatory drugs, aminoglycosides or some radiological contrasts^2,4. To preserve both normal and pathological kidney function, it is necessary to consider which nephrotoxic drugs may be particularly dangerous in elderly people, diabetics or those with heart failure, especially in situations of dehydration or hypovolaemia. In addition to maintaining fluid intake and giving the strictly necessary drugs with adequate doses, intervals and time, if the glomerular filtration is altered, it will be necessary to adjust the dose and carry out controls to detect a deterioration in renal function or hyperkalaemia associated with drugs⁵.