title: Perioperative Pharmacologic Management of Patients with End Stage Renal Disease.
abstract: The pharmacokinetics of numerous medications used in the perioperative period are altered in patients with end-stage renal disease. Clearance of drugs, or their metabolites, that are normally excreted by the kidney is markedly reduced in ESRD. In addition, patients with ESRD may also have alterations in gastrointestinal absorption, volume of distribution, protein binding, and metabolic clearance of pharmacologic agents. Finally, drug removal may be augmented during dialysis. All of these factors contribute to the need for dose adjustment of medications, including analgesics, anesthetics, neuromuscular blockers, and antimicrobial agents, which may be used in the perioperative management of the ESRD patient.
authors: Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
authors: Ameet
authors: A
authors: Karambelkar
authors: Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
authors: Riyaj
authors: R
authors: Kasekar
authors: Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.|Renal Section, Medical Service, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania.
authors: Paul M
authors: PM
authors: Palevsky
mesh_terms: D000700:Analgesics / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D006801:Humans; D007676:Kidney Failure, Chronic; D009466:Neuromuscular Blocking Agents / Q000627:therapeutic use*; D019990:Perioperative Care
chemical_list: D000700:Analgesics; D000900:Anti-Bacterial Agents; D009466:Neuromuscular Blocking Agents