title: [Drug pharmacokinetics in renal failure: What's new?].
abstract: The prevalence and incidence of chronic kidney disease (CKD) has steadily increased over the past two decades attributed to an important raise of cases of diabetes, hypertension and obesity, leading risk factors of renal failure. CKD is known to impair drug disposition of non-renally eliminated medications that may lead to unintended toxicity or lower therapeutic effect despite dose adjustment according to glomerular filtration rate (GFR). Modulation of metabolism enzymes (cytochrome P450, phase II) and drug transporters in various organs (intestines, liver, kidneys and brain) are being held responsible for altered pharmacokinetics where uremic toxins, inflammatory cytokines and parathyroid hormone, common factors present in CKD, may be considered possible culprits. This review gives a thorough summary of the recent preclinical, clinical studies and Food and Drug Administration (FDA) guidelines and allows a current understanding of drug absorption, distribution, metabolism and excretion in CKD.
authors: Service de néphrologie, centre de recherche de l'hôpital Maisonneuve-Rosemont, 5415, boulevard de l'Assomption, Montréal, Québec, Canada, H1T 2M4; Département de pharmacologie, faculté de médecine, université de Montréal, CP 6128, Succursale Centre-ville, Montréal, Québec, Canada, H3C 3J7.
authors: Judith
authors: J
authors: Naud
authors: Service de néphrologie, centre de recherche de l'hôpital Maisonneuve-Rosemont, 5415, boulevard de l'Assomption, Montréal, Québec, Canada, H1T 2M4; Département de pharmacologie, faculté de médecine, université de Montréal, CP 6128, Succursale Centre-ville, Montréal, Québec, Canada, H3C 3J7.
authors: Christopher
authors: C
authors: Dumayne
authors: Center for clinical pharmaceutical sciences, department of pharmacy and therapeutics, school of pharmacy, university of Pittsburgh, 808, Salk Hall, 3501, Terrace Street, Pittsburgh, PA, 15261 États-Unis.
authors: Thomas D
authors: TD
authors: Nolin
authors: Service de néphrologie, centre de recherche de l'hôpital Maisonneuve-Rosemont, 5415, boulevard de l'Assomption, Montréal, Québec, Canada, H1T 2M4; Département de pharmacologie, faculté de médecine, université de Montréal, CP 6128, Succursale Centre-ville, Montréal, Québec, Canada, H3C 3J7.
authors: François A
authors: FA
authors: Leblond
authors: Service de néphrologie, centre de recherche de l'hôpital Maisonneuve-Rosemont, 5415, boulevard de l'Assomption, Montréal, Québec, Canada, H1T 2M4; Département de pharmacologie, faculté de médecine, université de Montréal, CP 6128, Succursale Centre-ville, Montréal, Québec, Canada, H3C 3J7. Electronic address: vpichette.hmr@ssss.gouv.qc.ca.
authors: Vincent
authors: V
authors: Pichette
mesh_terms: D005919:Glomerular Filtration Rate; D006801:Humans; D009928:Organ Specificity; D004364:Pharmaceutical Preparations; D010599:Pharmacokinetics; D051437:Renal Insufficiency / Q000188:drug therapy* / Q000378:metabolism* / Q000473:pathology; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy* / Q000378:metabolism* / Q000473:pathology
chemical_list: D004364:Pharmaceutical Preparations
keywords: ABC transporters; Cytochrome P450; Cytochrome P450; Drug disposition; Insuffisance rénale; Kidney disease; Métabolisme de phase II; Pharmacocinétique; Pharmacokinetics; Phase II metabolism; Transporteurs ABC; Élimination des médicaments