Alteration of drug-protein binding in renal disease

Clin Pharmacokinet. 1984 Jan:9 Suppl 1:18-26. doi: 10.2165/00003088-198400091-00003.


The protein binding of acidic drugs but not basic drugs is decreased in serum from patients with poor renal function. This decreased binding is due to the retention of compounds that displace drugs from their binding sites on albumin. Phenytoin and valproic acid are the 2 drugs that require a change in the values for therapeutic levels to allow for this decreased binding.

MeSH terms

  • Humans
  • Kidney Diseases / metabolism*
  • Pharmaceutical Preparations / metabolism*
  • Protein Binding*
  • Serum Albumin / metabolism
  • Uremia / metabolism


  • Pharmaceutical Preparations
  • Serum Albumin