• V Launay-Vacher, T Storme, H Izzedine, and G Deray.
• Service de Néphrologie, Groupe Hospitalier Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, F75651 Paris. vincent.launay-vacher@psl.ap-hop-paris.fr
• Presse Med. 2001 Mar 31; 30 (12): 597-604.

AbstractDRUG PHARMACOKINETICS: One of the first steps in the clinical development of drugs consists in studies of their pharmacokinetics. Dosage and administration interval necessary to ensure secure and efficient plasma levels are derived from the values of pharmacokinetic parameters. Renal disease usually implies multiple pathophysiological modifications that generate alteration in drugs pharmacokinetic profile. Those modifications mainly occur on elimination phase but also to a significant extent on absorption and distribution. PATHOPHYSIOLOGICAL CHANGES: In this article we describe potential alteration in drugs absorption, distribution (volume of distribution, binding to plasma proteins), hepatic or renal metabolism, and parent compound and/or metabolites elimination in patients with renal insufficiency. Furthermore, in patients with end-stage renal disease treated by dialysis, drugs are likely to be removed by extracorporal epuration and dosage and/or interval modifications should thus be applied to treatments in those patients.

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