Blanco Victoria E, Hernandorena Carolina V, Scibona Paula, Belloso Waldo, Musso Carlos G
Human Physiology Department, Instituto Universitario del Hospital Italiano de Buenos Aires, Potosí 4234, C1199AC CABA Buenos Aires, Argentina.
Pharmacology Division, Internal Medicine Department, Hospital Italiano de Buenos Aires, C1199 ABH Buenos Aires, Argentina.
Healthcare (Basel). 2019 Jan 14;7(1):10. doi: 10.3390/healthcare7010010.
Acute kidney injury (AKI) is a common problem in hospitalized patients that is associated with significant morbid-mortality. The impact of kidney disease on the excretion of drugs eliminated by glomerular filtration and tubular secretion is well established, as well as the requirement for drug dosage adjustment in impaired kidney function patients. However, since impaired kidney function is associated with decreased activity of several hepatic and gastrointestinal drug-metabolizing enzymes and transporters, drugs doses adjustment only based on kidney alteration could be insufficient in AKI. In addition, there are significant pharmacokinetics changes in protein binding, serum amino acid levels, liver, kidney, and intestinal metabolism in AKI, thus the determination of plasma drug concentrations is a very useful tool for monitoring and dose adjustment in AKI patients. In conclusion, there are many pharmacokinetics changes that should be taken into account in order to perform appropriate drug prescriptions in AKI patients.
急性肾损伤（AKI）是住院患者中常见的问题，与显著的发病率和死亡率相关。肾脏疾病对通过肾小球滤过和肾小管分泌消除的药物排泄的影响已得到充分证实，以及肾功能受损患者调整药物剂量的必要性。然而，由于肾功能受损与几种肝脏和胃肠道药物代谢酶及转运体的活性降低有关，仅基于肾脏改变来调整药物剂量在急性肾损伤中可能并不充分。此外，急性肾损伤时蛋白质结合、血清氨基酸水平、肝脏、肾脏和肠道代谢存在显著的药代动力学变化，因此测定血浆药物浓度是监测和调整急性肾损伤患者药物剂量的非常有用的工具。总之，为了对急性肾损伤患者进行适当的药物处方，需要考虑许多药代动力学变化。
