Renal Impairment By Nom Kumar Naik

1. Renal impairment
By
Bhukya Nom Kumar Naik
5th Pharm.D
17AB1T0005

2. 1.Kidney is an important organ.
2.Kidney is responsible for
• Fluid balance,
• Electrolyte balance,
• Removal of drugs and Drug metabolites from the body.
3. When kidney function decreases due to any reason, it is called renal impairment.
4.Some of the more common cause of the kidney failure or renal impairment are :
• Disease or
• injury or
• drug intoxication
5. There are some common causes of kidney failure are Hypertension, diabetes, nephritis,
and certain drugs (aminoglycosides, phenacetin, and heavy metals).
Hypertension :
Chronic overloading of kidney with fluid and electrolytes may leads to kidney insufficiency.
(High BP may cause damage to kidney blood vessels there may be reduced work efficiency
of kidneys in removing waste products from blood ultimately Raise in BP even more. It is a
cyclic process)

3. Diabetes Mellitus :
The disturbance of sugars metabolism and acid base balance may lead or pre-disposing a patient to
degenerative renal disease ( diabetes may cause damage to blood vessels and nerve damage that may
cause difficulty in emptying in bladder).
Pyelonephritis :
Inflammation and deterioration of Pyelo-nephrons due to infection,antigens or other causes.
Hypovolemia :
Hypovolemia is a condition where reduced blood flow to organs like heart, kidneys, brain
etc…reduced renal blood flow may leads to renal ischemia or damage.
Drugs :
Certain drugs taken chronically may cause irreversible kidney damage. Eg. Aminoglycosides.
Nephroallergens :
Certain compounds may produce an immune type sensitivity reaction with nephrotic syndrome. Eg.
Quartan malaria nephrotoxic serum.

4. 6.Impairment or degeneration of kidney function affects the Pharmacokinetics parameters of Drug in
the body.
7. Drug pharmacokinetics parameters like elimination rate constant, t1/2 and distribution
etc…..change with renal impairment.
8. Acute disease or major injury to kidney may cause uremia, where it is defined as “High levels of
UREA in blood ”
9. Uremia may cause ,decreased in GFR and that may cause accumulation of body fluids and
nitrogenous products into body.
10. A decrease in GFR is associated with a decrease in drug clearance (Active clearance of drug).
This increases the biological half-life of drugs in the body.
11. However, special dosing consideration to account for such PK and PD parameters alterations.

5. THANK YOU