title: An appraisal of antiretroviral drugs in hemodialysis.
abstract: BACKGROUND
  Acquired immunodeficiency syndrome (AIDS)-related kidney disorders concern 30% of those patients and can lead to end-stage renal disease (ESRD; 6 to 10%). Therefore, the administration of antiretroviral drugs in human immunodeficiency virus (HIV) patients with nephropathy is not uncommon.
  
  
  METHODS
  The influence of ESRD on the different phases of the pharmacokinetic profile of drugs in general is examined in light of bioavailability, distribution, protein binding, metabolism, and elimination. Then, the pharmacokinetics of antiretroviral drugs in hemodialysis are detailed.
  
  
  RESULTS
  From these data, dosing recommendations are given for nucleoside reverse transcriptase inhibitors (NRTIs), non-NRTIs, and protease inhibitors (PIs).
  
  
  CONCLUSIONS
  Dosage adjustments are often necessary for patients with renal insufficiency. These adaptations have to be carefully performed to optimize drug exposure and reduce the risk of side effects.
authors.affiliation: Department of Nephrology, Pitie Salpetriere Hospital, Paris, France. hassan.izzedine@psl.ap-hop-paris.fr
authors.forename: H
authors.initials: H
authors.lastname: Izzedine
authors.forename: V
authors.initials: V
authors.lastname: Launay-Vacher
authors.forename: A
authors.initials: A
authors.lastname: Baumelou
authors.forename: G
authors.initials: G
authors.lastname: Deray
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000188:drug therapy; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics*; D019540:Area Under Curve; D004334:Drug Administration Schedule; D017408:Guidelines as Topic; D006801:Humans; D015394:Molecular Structure; D011480:Protease Inhibitors / Q000493:pharmacokinetics; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000150:complications* / Q000378:metabolism / Q000628:therapy; D018894:Reverse Transcriptase Inhibitors / Q000493:pharmacokinetics
chemical_list: D019380:Anti-HIV Agents; D011480:Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors