What effect does acute kidney injury have on drug dosing in the ICU?

Acute kidney injury (AKI) significantly impacts drug dosing because many medications are eliminated from the body through renal excretion. When kidney function is impaired, the ability to clear these medications is reduced, which can lead to an accumulation of the drug in the body. This accumulation raises the risk of drug toxicity, especially with renally excreted medications. Therefore, to ensure patient safety, careful dose adjustments are often necessary in the presence of AKI.

In clinical practice, healthcare providers must perform regular assessments of the kidney function, typically using measures like serum creatinine and estimated glomerular filtration rate (eGFR), to guide appropriate dosing regimens. This approach helps to minimize the risk of adverse effects and toxicity associated with the medications that rely heavily on renal clearance.