Academic Day Seminars

ADS – Dialysis Modalities and Drug Dosing

This was an amazing ADS to have a better understanding about the mystery that is renal impairment, dialysis and renal drug dosing!

A practical approach to dose adjustment in renal impairment:

  • Obtain patient history and relevant info
  • Estimate GFR (or consider impact of dialysis)
  • Review current medications
  • Create individualized dosing regimen
  • Monitor for efficacy and toxicity
  • Revise regimen PRN

Some great resources that were introduced to us include:

  • What was interesting about this, was how little evidence there is for these recommendations (e.g. not RCT, sometime no citations, etc.)

Drugs that often need drug adjustment is: BANDDCAMP 🙂

  • Beta-blockers
  • ACE-inhibitors/ARBs
  • NSAIDs
  • Diuretics
  • Diabetic medications
  • Cholesterol meds
  • Antimicrobials (antibiotics, antifungals, antivirals)
  • Miscellaneous: allopurinol, colchicine, digoxin, H2RAs
  • Psychotropics:

Dose adjustment strategies: assessing whether to change the dose or the interval. Some examples where we would change dose vs. interval is if the antibiotic is time-dependent vs concentration dependent.

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