The influence of chronic renal failure on drug metabolism and transport.
Chronic renal failure (CRF) has been shown, in animal models and clinical studies, to significantly reduce nonrenal clearance and to alter the bioavailability of predominantly metabolized drugs. Phase II reactions and drug transporters such as P-glycoprotein (P-gp) and organic anion transporting polypeptide (OATP) are also affected. High levels of parathyroid hormone (PTH), cytokines, and uremic toxins are implicated in some of these effects, which have a clinically significant impact on drug disposition and increase the risk of adverse drug reaction.
Division of Nephrology, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA. adreisbach@umsmed.edu
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D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000378:metabolism*; D000818:Animals; D001682:Biological Availability; D001692:Biological Transport; D002986:Clinical Trials as Topic; D016207:Cytokines / Q000378:metabolism; D064420:Drug-Related Side Effects and Adverse Reactions; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology*; D027361:Organic Anion Transporters / Q000378:metabolism*; D010281:Parathyroid Hormone / Q000378:metabolism; D004364:Pharmaceutical Preparations / Q000378:metabolism*; D014511:Uremia / Q000378:metabolism
D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D016207:Cytokines; D027361:Organic Anion Transporters; D010281:Parathyroid Hormone; D004364:Pharmaceutical Preparations