Emerging evidence of the impact of kidney disease on drug metabolism and transport

Clin Pharmacol Ther. 2008 Jun;83(6):898-903. doi: 10.1038/clpt.2008.59. Epub 2008 Apr 2.


Several lines of emerging evidence indicate that kidney disease differentially affects uptake and efflux transporters and metabolic enzymes in the liver and gastrointestinal (GI) tract, and uremic toxins have been implicated as the cause. In patients with kidney disease, even drugs that are eliminated by nonrenal transport and metabolism could lead to important unintended consequences if they are administered without dose adjustment for reduced renal function. This is particularly so in the case of drugs with narrow therapeutic windows and may translate into clinically significant variations in exposure and response.

Publication types

  • Review

MeSH terms

  • Animals
  • Biological Transport / drug effects
  • Biological Transport / physiology
  • Humans
  • Kidney / drug effects
  • Kidney / metabolism
  • Kidney Diseases / drug therapy
  • Kidney Diseases / metabolism*
  • Metabolic Clearance Rate / drug effects
  • Metabolic Clearance Rate / physiology
  • Pharmaceutical Preparations / administration & dosage
  • Pharmaceutical Preparations / metabolism*


  • Pharmaceutical Preparations