Drug therapy in the patient with renal impairment

Abstract

Introduction: The kidney suffers a triple pharmacological relationship to drugs: the first is the renal damage as a direct effect of such drugs as phenacetin and heavy metals. In such cases the area of greatest damage is the papillary region of the renal medulla by reason of the highest drug concentration and lowest oxygen tension found here. The second type of damage may result from hypersensitivity to certain drugs while the third pharmacological relation is the accumulation of drugs in the blood especially those whose active form is principally excreted by the kidney in cases where the kidney is becoming insufficient.