The Renal Drug Handbook. 4th ed.

Abstract

This handbook provides detailed drug information to assist healthcare professionals to safely dose medications in patients with kidney disease. It is also available online which I suspect will extend the readership from predominantly renal pharmacists to other groups. The Preface outlines how to use the monographs and basic drug dosing advice including valuable information on the use of estimated glomerular filtration rate (eGFR). Over 800 drug monographs are arranged in alphabetical order, making navigation easy. Each monograph has a standard format, which includes information about the drug’s clinical use, its dose in normal renal function, and its pharmacokinetics and metabolism. If a dose reduction is required in renal impairment, the dose is given either in milligrams with the appropriate frequency, or as a percentage of the normal dose. Dosing for patients undergoing renal replacement therapies is also included. If relevant, other useful information about drug interactions, administration, adverse effects more commonly seen in patients with kidney impairment and monitoring is also included. The section on pharmacokinetics is particularly useful as it gives the prescriber access to information so that first principles can be applied. Although I would like to have seen more referencing within the individual monographs, a list of texts and websites is included in the Preface. One limitation is that the handbook is a UK publication so some of the drugs and dosing recommendations are not relevant to the Australian situation. Perhaps a consideration for future editions might be to include some general comments on the use of various drug classes in patients with renal disease. Overall I applaud the authors for updating this publication, which is an extremely useful resource for guiding prescribing in patients with kidney impairment.