Chronic kidney disease belongs among the most frequent clinical problems, but often remains underdia-gnosed. Decreased renal function affects all pharmacokinetic properties of drugs.
Thus, patients with chronic kidney disease are at increased risk of adverse drug effects - especially overdoses of drugs that are primarily eliminated by the kidneys. Other frequent problems in patients with kidney disease are polymorbidity and polypharmacy.
Before using any new medication, determination of the glomerular filtration rate is obligatory, since the value of serum creatinine alone is not a reliable indicator of kidney function. The dosing of drugs eliminated mainly or solely by the kidneys can be adjusted by reducing the dose, prolonging the interval between doses, or combining both these methods.