Simposio 5: Manejo de fármacos en diabetes y enfermedad renal crónica

Symposium 5: Renal involvement in diabetes: beyond the kidney Medication management in diabetes and chronic kidney disease Renal circulation represents 25% of the systolic volume, for which kidneys receive an amount of drug in circulation superior to any other organ. This load could increase in hyperfiltration, but does not decrease in the same proportion as the renal function, increasing the amount of drug per functional nephron during chronic kidney disease (CKD). CKD modifies pharmacodynamics in different ways. Through the alteration of: 1- the composition of the body fluids distribution compartment, 2- the plasma proteins synthesized in an environment which does not eliminate toxics, adding the carbamylation to the glycosylation of diabetes, 3- the environment in which the drug-receptor union takes place, and 4- the systematic metabolic alterations. The decrease of renal depuration increments the hepatic and enzymatic metabolic load, altering the half-life of the drugs and the metabolites.