Special Populations: Renal Impairment

Abstract

Kidney and liver are the main organs involved in the elimination of drugs. In general, the elimination capacity of the kidney is lower than of the liver, because of the smaller organ size and associated blood flow. Renal excretion can be limited by glomerular filtration rate in case of passive excretion or transporter capacity by total renal blood flow and in case of active secretion. Impaired renal function is a rather common condition in patients. Therefore, both dedicated studies in patients with renal impairment and pharmacokinetic investigations via means of population pharmacokinetics are routinely used in drug development to investigate if a dose adjustment needs to be applied in this vulnerable population.