Emerging evidence of the impact of kidney disease on drug metabolism and transport
Emerging evidence of the impact of kidney disease on drug metabolism and transport
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DOI：
10.1038/clpt.2008.59
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发表时间：
2008-06-01
影响因子：
6.7
通讯作者：
Pichette, V.
中科院分区：
文献类型：
--
作者：
Nolin, T. D.;Naud, J.;Pichette, V.
一些新出现的证据表明，肾脏疾病对肝脏和胃肠道(GI)的摄取和外排转运体以及代谢酶有不同的影响，尿毒症毒素被认为是病因。在肾病患者中，即使是被非肾脏转运和代谢消除的药物，如果在不调整剂量以降低肾功能的情况下使用，也可能导致重要的意想不到的后果。这在治疗窗口狭窄的药物中尤其如此，并可能转化为暴露和反应的临床显著变化。
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.