Renal impairment

Renal impairment is reduced kidney function that can diminish filtration, secretion, and excretion of substances. It may be acute or chronic and can affect fluid, electrolyte, and waste balance.

Glomerular filtration rate: The volume of fluid filtered from blood by the kidney glomeruli per unit time. A falling filtration rate is a central measure of impaired kidney function.
Serum creatinine: A blood measurement of creatinine, a waste product generated by muscle metabolism. Its concentration often rises when impaired kidneys clear creatinine less effectively.
Renal dosing: Adjustment of medication doses or intervals to account for reduced kidney clearance. Reduced clearance can increase drug exposure unless treatment is adjusted.
Kidney failure: Severe loss of kidney function that prevents adequate maintenance of the body's internal environment without treatment. Failure is a more advanced state than the broader range of renal impairment.
Creatinine clearance: An estimate of kidney filtration calculated from creatinine in urine and blood over time. It links impaired filtration to the clearance of a measurable waste product.
Cystatin C: A blood protein used to estimate kidney filtration, produced by most nucleated cells. It can help assess filtration when creatinine estimates may be misleading.
Drug clearance: The removal of a drug from the body through metabolism and excretion. Kidney impairment slows clearance for medicines eliminated substantially in urine.
Chronic kidney disease staging: Classification of chronic kidney disease by estimated filtration rate and markers of kidney damage. Staging differentiates degrees of persistent impairment rather than treating them as equivalent.
Tubular secretion: The movement of substances from blood into the fluid inside kidney tubules. Reduced secretion can impair drug and waste removal beyond filtration alone.
Estimated glomerular filtration rate: A calculated estimate of kidney filtration based on blood markers and other patient characteristics. It provides a practical measure for staging and monitoring renal impairment.

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