Prescribing in kidney disease
Four questions for every drug
- Four separate questions for every drug in CKD:
- 1. Is it nephrotoxic?
- 2. Is it (or an active metabolite) renally cleared?
- 3. Does CKD change what it does? (altered protein binding, volume of distribution, receptor sensitivity)
- 4. Should it be withheld when the patient is sick?
- *The commonest prescribing error in CKD is dosing by BSA-normalised eGFR instead of absolute clearance*
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