Chronic kidney disease: pharmacological considerations for the dentist.

Abstract

BACKGROUND:

Patients with chronic kidney disease (CKD) represent a challenge for the dentist seeking to prescribe medications. Understanding the medical management of renal insufficiency and the pharmacokinetics of common dental drugs will aid clinicians in safely treating these patients.

TYPES OF STUDIES REVIEWED:

The authors reviewed the literature concerning the medical and pharmacological management of CKD. They reviewed the pharmacokinetic effects of drugs described in case reports and research articles and obtained from them recommendations regarding the use of drugs and adjustment of dosages.

CLINICAL IMPLICATIONS:

Because CKD is progressive, patients have varying levels of renal function but do not yet have end-stage renal disease. Some drugs that dentists prescribe commonly may worsen a patient's renal function, lead to drug toxicity or both. Managing the care of patients and prescribing medications tailored to their needs begin with a recognition of the patient with renal disease at risk of developing adverse effects. Clinicians can identify these patients from information obtained in their medical histories and from the drugs they may be taking.

CONCLUSIONS:

To treat patients with kidney disease, clinicians must recognize those at risk, have knowledge of the pharmacokinetic changes that occur and recognize that adjustment of drug dosages often is needed.

• Authors: William Brockmann, Mostafa Badr
• Journal: Journal of the American Dental Association (1939) (J Am Dent Assoc) Vol. 141 Issue 11 Pg. 1330-9 (Nov 2010) ISSN: 1943-4723 [Electronic] England
• PMID: 21037190 (Publication Type: Journal Article, Review)

Chemical References

• Pharmaceutical Preparations, Dental
• Renal Agents

Topics

• Dental Care for Chronically Ill
• Drug Interactions
• Glomerular Filtration Rate (drug effects, physiology)
• Humans
• Pharmaceutical Preparations, Dental (pharmacokinetics, therapeutic use)
• Renal Agents (pharmacokinetics, therapeutic use)
• Renal Insufficiency, Chronic (drug therapy, physiopathology)
• Risk Factors