Anwar Habib and Razi Ahmad*


Chronic kidney disease (CKD) is one of the major causes of morbidity and mortality among noncommunicable diseases in India. Majority of the patient chronic kidney disease (CKD) also suffers from 2 to 4 comorbid conditions, hypertension, diabetes mellitus and coronary artery disease tops the list of these comorbid conditions and need an average of 6-8 medications that predispose these patients to medication related problem in the form of both therapeutic failure and drug toxicity mostly because of the ignorance of the prescribing physician about the pharmacokinetic and pharmacodynamic changes that occurs in the various stages of chronic kidney disease that needs drug dose and frequency adjustment especially in the patients of end stage renal disease, the general guidelines provided by different agencies for dose adjustment cannot be applied for all the patients because the pharmacokinetic and pharmacodynamic changes in all the patients are not same it depends on a large number of factors like age, sex, duration and severity of CKD and frequency and dose of hemodialysis received by these patients and also the fluid accumulation in between the subsequent hemodialysis etc. So individual dose adjustment depending on pharmacokinetic and pharmacodynamic changes in a patient will improve the quality and productivity of these patient.

Keywords: CKD, Pharmacotherapy, hemodialysis.

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