Abstract
Simple SummaryAdjusting drug dosages in dogs and cats with chronic kidney disease (CKD) can be challenging in clinical practice due to the lack of specific indications in the current literature; moreover, the evaluation of renal function through the measurement of glomerular filtration rate (GFR), which is unanimously considered as a requisite for most adjustment strategies, is often hard to perform in clinical settings. Therefore, the present review aims to provide practical guidelines for dosage adjustment in CKD patients through an overview of the available literature.Chronic kidney disease is a common kidney disorder in adult and aged dogs and cats; the management of associated complications and comorbidities generally requires a life-long medical treatment to ensure a good quality of life of affected patients. However, indications and the literature on drug dosing in dogs and cats with chronic kidney disease are often lacking. The aim of this review is to revise the current literature on drug dosing in canine and feline patients with renal impairment, with a special focus on the most commonly used medications to manage chronic kidney disease and possible comorbidities.
Highlights
Chronic Kidney Disease and Implications in Drug DosingChronic kidney disease (CKD) is the most commonly recognized form of kidney disorder in dogs and cats and, in most instances, it represents an irreversible and progressive condition [1]
The present review describes the mechanisms of altered drug handling in CKD and discusses the rationale of dose adjustment regimens in the most commonly used classes of medication in CKD management and related complications; the effective need to adjust the dose of other commonly used drugs in clinical practice, and their potential impact on renal function, will be analyzed
Glomerular filtration rate is defined as the volume of ultrafiltrate produced by glomerular filtration per unit of time and can be measured using the urinary or plasmatic clearance of appropriate markers, where the clearance describes the relationship between the transfer rate of the marker and its concentration in urine or plasma, respectively [14,15]
Summary
Chronic Kidney Disease and Implications in Drug Dosing. Chronic kidney disease (CKD) is the most commonly recognized form of kidney disorder in dogs and cats and, in most instances, it represents an irreversible and progressive condition [1]. The prevalence of CKD has been estimated to be 0.5–1.0% in dogs and. The conservative medical management of CKD consists of a supportive and symptomatic therapy designed to ameliorate clinical signs of uremia, correct fluid and electrolyte imbalance, provide adequate nutritional requirements and slower the progression of renal failure [5]. Antihypertensive and antiproteinuric drugs, phosphate binders, antiemetic and antacid medications are usually administered to manage the clinical signs and long-term complications related to renal failure [5,6,7]
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