Drug Use in Chronic Kidney Disease

Patients with chronic kidney disease may show altered pharmacokinetics and pharmacodynamic responses to many drugs in comparison to patients with normal renal function. Therefore, effective and safe drug usage is difficult in patients with chronic kidney disease and particularly in dialysis patients. Additionally, some drugs may have nephrotoxic effects leading to further deterioration in kidney function, especially in high-risk kidney patients. Another problem to be considered in dialysis patients is the removal of some drugs by the dialysis procedure itself, necessitating dose adjustments and additional doses for certain drugs. Due to of all these reasons above, it is necessary to practice appropriate drug use and carefully select patients in various stages of chronic kidney disease. In our review, we aimed to outline the fundamental rules of drug use in chronic kidney disease and dialysis patients.