Anaesthesia and intensive care
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A knowledge of pharmacokinetic principles is essential to understand dosage modification for drugs used in patients in renal failure. Dosage modification is indicated either where drugs have a low therapeutic index, or where renal mechanisms play a major role in drug elimination. ⋯ In addition to effects on drug elimination, renal failure may also alter drug absorption, distribution, protein binding and metabolism. Dialysis regimens, by eliminating drugs to a greater or lesser degree, have implications for drug therapy.