Thursday, February 15, 2018

Drug level monitoring in ICU

Q: End-stage renal disease (ESRD) and AKI can also effect hepatic drug metabolism?

A) True
B) False

Answer: True

An important but not always appreciated fact in the ICU is that liver drug metabolism may also change in patients who develop acute kidney injury (AKI). Overall, end-stage renal disease (ESRD) and AKI both reduce hepatic drug metabolism. It calls for close vigilance of drugs level monitoring, irrespective of route of excretion.


1. Vilay AM, Churchwell MD, Mueller BA. Clinical review: Drug metabolism and nonrenal clearance in acute kidney injury. Crit Care 2008; 12:235. 

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