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VOLUME 24 , ISSUE S3 ( April, 2020 ) > List of Articles

INVITED ARTICLE

Drug Dosing in Critically Ill Patients with Acute Kidney Injury and on Renal Replacement Therapy

Sai Saran, Namrata S Rao

Keywords : Acute kidney injury, Critically ill, Drug dosing

Citation Information : Saran S, Rao NS. Drug Dosing in Critically Ill Patients with Acute Kidney Injury and on Renal Replacement Therapy. Indian J Crit Care Med 2020; 24 (S3):129-134.

DOI: 10.5005/jp-journals-10071-23392

License: CC BY-NC 4.0

Published Online: 00-04-2020

Copyright Statement:  Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Acute kidney injury (AKI) complicates in around 40–50% of patients in intensive care units (ICUs), and this can account for up to 80% mortality, especially in those patients requiring renal replacement therapy (RRT). Appropriate drug dosing in such patients is a challenge to the intensivists due to various factors such as patient related (appropriate body weight, organ clearance, serum protein concentration), drug related [molecular weight (MW), protein binding, volume of distribution (Vd), hydrophilicity, or hydrophobicity], and RRT related (type, modality of solute removal, filter characteristics, dose, and duration). Therapeutic drug monitoring (TDM) of drugs can be a promising solution to this complex scenario to titrate a drug to its clinical response, but it is available only for a few drugs. In this review, we discussed drug dosing aspects of antimicrobials, sedatives, and antiepileptics in critically ill patients with AKI on RRT.


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