Drugs and kidney in the elderly patient

Abstract

With aging, different factors contribute to change the pharmacokinetics and pharmacodynamics of drugs and therefore can cause variable and unpredictable clinical outcomes.

As we age, the body composition changes, liver and kidney blood flow decreases resulting in reduced function of both organs and therefore decreased metabolism and insufficient elimination of drugs. On the other hand, the elderly are at greater risk in the use of drugs both for the reasons listed above and for the presence of diseases that determine the intake of numerous drugs that can interact with each other. The lower physiological reserves and the conditions related to fragility contribute to the occurrence of toxicity or adverse events related to therapy. To these causes are added factors related to the health system such as the fragmentation of care with multiple prescribers and inadequate training in treating the elderly patient. The need for correct reconnaissance and pharmacological reconciliation is therefore of fundamental importance.

The frequency of adverse drug reactions is about three to ten times higher in the elderly patient and clinically the adverse reactions are more severe. Furthermore, there is a close relationship between the incidence of adverse reactions and renal function which is in turn responsible for changes in the pharmacokinetics and pharmacodynamics of drugs and the kidney is very often the target organ of adverse drug reactions.

 

Keywords: Drugs, kidney, adverse drugs reactions, drugs toxicity

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