Renal excretion clinical implications

Masereeuw R, Russel FG. Mechanisms and clinical implications of renal drag excretion. Drug Metab Rev. 2001 33 299-351. 

Many drugs and their metabolites are excreted via the kidneys. The most important clinical implications of altering renal excretion involve the use of drugs that are excreted in their unchanged form or in the form of an active metabolite. Thus, substances with pharmacological activity are being reabsorbed or excreted to a greater extent when renal excretion is altered. 

The main role of the kidney in the process of drug metabolism consists in the excretion of the many, more or less pharmacologically active metabolites formed in the liver [8]. Needles to say that renal insufficiency may result in the accumulation of metabohtes and, if pharmacological active, may result in serious side effects/ toxicity [33]. Renal metabolism of drug-xenobiotics and its contribution to elimination has been inadequately explored so that clinical implications are for the most part inferred from animal models or speculative. 

Masereeuw, R., 8c Russel, F. G. M. (2001). Mechanisms and clinical implications of renal drug excretion. Drug Metabolism Reviews, 33, 299-351. 

Clinical state and salt implicated Blood concentration f/imolL ] Urinary excretion l/imolL ] Renal clearance [mLmin... 

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