Renal Insufficiency

Various renal glomerular, tubulointerstitial, and vascular disorders can accompany gastrointestinal (GI) disease and are often exhibited as acute kidney injury or chronic kidney disease. Acute kidney injury and chronic kidney disease are heterogenous conditions that have very different effects on the pharmacokinetics and pharmacodynamics of drugs and prescribing an appropriate initial and maintenance dose requires a rational approach and understanding of those processes. Drugs and toxins can also frequently be associated with various glomerular, tubulointerstitial, and vascular renal pathology. Direct injury to renal intrinsic cells, hemodynamic changes, and the induction of immunologic injury are the most common pathogenic pathways. Understanding the mechanisms involved and early recognizing of clinical presentation is important in detection as well as in the prevention of renal injury.