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Renal handling of drugs and xenobiotics

  • Chapter
Clinical Nephrotoxins

Pharmacology and clinical pharmacology define the desirable and undesirable effects of drugs and xenobiotics whereas pharmacokinetics defines the various processes that are involved in absorption - distribution - elimination of these agents. Needless to say that the former may strongly influence the latter.

The kidney and the liver have complementary functions in the elimination of drugs and xenobiotics. Lipophilic non-ionic substances of molecular weight higher than 300-500 dalton and highly bound to proteins appear to be eliminated by the liver, while the kidney prefers hydrophilic substances of molecular weight smaller than approximately 500 daltons. Metabolism occurs predominantly in the liver, transforming the original substance into more polar and more hydrophilic metabolites, which became dependent on the kidney for elimination. Consequently, the majority of all drugs and xenobiotics in one way or another have to pass through the kidney. In addition to this important “gateway” function of substances, which are not always without side-effects, the kidney itself is particularly sensitive to drugs and xenobiotics.

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  1. Université de Lausanne, Switzerland

    FranÇoise Roch-Ramel

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  1. Marc E. De Broe
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  1. Laboratory of Pathophysiology Universiteitsplein 1, University of Antwerp, Wilrijk, B-2610, Belgium

    Marc E. De Broe

  2. Division of Nephrology, Hypertension and Clinical Pharmacology, Oregon Health Sciences University, 3181 SW Sam Jackson Park Road, Portland, OR, 97201, USA

    George A. Porter

  3. Legacy Good Samaritan Hospital, 1015 NW 22nd Avenue, W004, Portland, OR, 97201, USA

    William M. Bennett

  4. Groupe Hôspitalier Pitié Salpétrière Service De Néphrologie 83, Boulevard de l′Hôpital, Paris, F-75013, France

    Gilbert Deray

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De Broe, M.E., Roch-Ramel, F. (2008). Renal handling of drugs and xenobiotics. In: De Broe, M.E., Porter, G.A., Bennett, W.M., Deray, G. (eds) Clinical Nephrotoxins. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-84843-3_3

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