Can you explain why people with poor kidney function are at risk for problems with toxicity?
If the medication has been metabolized by the liver before excretion, isn't the medication mostly (or completely) inactive?
Thank you for your reply.
To understand the effect of kidney impairment on drug toxicity, it can be helpful to think of drug metabolism and excretion as a two step process. The first step takes place in the liver where drugs are metabolized and the second step takes place in the kidney where drugs are eliminated from the body in urine. Not all drugs are ready to be eliminated through the kidneys in their natural state. The liver prepares drug molecules for elimination; these are called metabolites.
There is some variability to this: some drugs are metabolized in different tissues (other than the liver), and some drugs are eliminated through the gut along with waste products or feces (and not through the kidneys in urine). Lastly, some drugs have more active metabolites than other drugs do, and not all drugs are inactive after liver metabolism.
If someone has poor kidney function, the drug metabolites may begin to accumulate, as the body cannot eliminate them properly. Again, there is a lot of variables in this process, but this is essentially why drug toxicity is a concern with kidney impairment.
Copyright 1994-2017MedHelp International.All rights reserved. MedHelp is a division of Aptus Health.
The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. Med Help International, Inc. is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. We offer this Site AS IS and without any warranties. By using this Site you agree to the following Terms and Conditions. If you think you may have a medical emergency, call your physician or 911 immediately.