How to Use Medicine in Renal Insufficiency Stage

2018-07-30 15:25

How to Use Medicine in Renal Insufficiency StageDrug metabolism and excretion are affected when kidney disease progresses to renal insufficiency stage. For normal kidney patients, the same medicine and same dose may be safe, but for renal insufficiency patients, they may exacerbate kidney damage. Therefore, patients with renal insufficiency cannot choose drugs simply by whether they can treat the diseases, but by considering whether the drugs can cause kidney damage or not, especially when the glomerular filtration rate (GFR) has reduced. Now let’s see how to use medicine in renal insufficiency stage in detail.

Notes for medication of renal insufficiency

1. Under the principle of choosing small or no nephrotoxic drugs, to select drugs with less renal excretion.

Patients with renal insufficiency should be especially careful about the use of drugs. Do not use those drugs that can cause kidney damage. And use some drugs with less kidney damage instead, or use them in short-term.

Drugs that are primarily excreted in the kidney should not be selected as far as possible. When kidney excretion is about 40%, it can cause drug damage.

2. Smaller quantity, better quality

Patients with renal insufficiency often suffer from multiple complications or other diseases. Before treatment, a systematic and comprehensive analysis should be made on the patients' own diseases so as to formulate a set of suitable treatment plan. To choose a few drugs that work, rather than a bunch of drugs that don't work.

How are medicine used for renal insufficiency patients?

For example,

Anti-hypertensive drugs

ACEI, ARBs: for patients with GFR < 45 ml/min/1.73m2, GFR and serum potassium levels should be evaluated after 1 week of low dose initiation.

β-blocker: when GFR<30ml/min/1.73㎡, dose should be cut half.


NSAIDs: It can not be used for long-term when GFR<60ml/min/1.73㎡. It should be avoided when GFR<30ml/min/1.73㎡.

Anti-bacterial medicine

Aminoglycosides: you should reduce dose or prolong the interval of medication when GFR<60ml/min/1.73㎡


Sulfonylureas: When GFR<30ml/min/1.73㎡, the use of glycemic drugs metabolized by the liver requires reduction.

Insulin: When GFR<30ml/min/1.73㎡, reduce the dose.

Metformin: When GFR<30ml/min/1.73㎡, avoid its intake.

Now you are clear about how to use medicine in renal insufficiency stage. For more information on kidney failure treatment, please leave a message below or contact online doctor.

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