Lecture 16: Drugs and the kidney

Question 1

What are the two major effect of Impaired Renal Function on Drug Therapy

Answer 1

1. Toxicity - Increased toxicity: the drug is going to hang around for a long time as it takes longer to be excreted by the kidneys. Can build up to toxic levels.
2. Ineffective treatment - If you want the drug to be in the urine to treat- may be an ineffective treatment as it cannot reach the kidney

Question 2

What are the stages of Chronic Kidney Disease

Answer 2

5 stages

Stage 1: Normal GFR > 90 ml/min/1.73m2

Stage 2: Early CKD GFR 60-89 ml/min

Stage 3: Moderate CKD GFR 30-59 ml/min

Stage 4: Severe CKD GFR 15-29

Stage 5: End-stage renal disease GFR < 15ml/min

Question 3

At what stage of chronic kidney disease do symptoms arise normally

Answer 3

Stage 3

Question 4

Name some drugs that affect the perfusion pressure in the afferent arteriole

Answer 4

NSAIDs - due to lack of prostaglandins

ACE inhibitors

Question 5

Define nephrotoxicity

Answer 5

It is a poisonous effect of some substances, both toxic chemicals and medications, on renal function.