Medication in Chronic Kidney Disease

Abstract

Chronic kidney disease (CKD) is a common disorder that is associated with multiple comorbidities and complications. The evidence for medications in patients with CKD is still insufficient. Several factors should be considered when different medications were selected in patients with CKD, such as the altered drug absorption and distribution. Because most pharmacokinetic data are collected from the trials which usually do not include patients with CKD, the evidence and the guidelines for the treatment of a general population might not be suitable for patients with CKD. Commonly used medicines in patients with CKD such as adrenal glucocorticoids, immunosuppressants, diuretics, inhibitors of the renin-angiotensin-aldosterone system, anticoagulation agents, antibacterial agents, and traditional Chinese medicines are described. Patients with CKD often need multiple medications for treatment of complications, and most drugs are excreted through the kidneys of a prototype or metabolite, thus most therapies should be adjusted according to renal function to avoid side effects of drug accumulation.