International Journal of Molecular Sciences | |
Xenobiotic Metabolism: The Effect of Acute Kidney Injury on Non-Renal Drug Clearance and Hepatic Drug Metabolism | |
John Dixon2  Katie Lane2  Iain MacPhee1  | |
[1] Division of Clinical Sciences, St. George’s, University of London, London SW17 0RE, UK;General Intensive Care Unit, St. George’s Hospital, London SW17 0QT, UK; E-Mails: | |
关键词: acute kidney injury; cytochrome P450; drug metabolism; pharmacogenetics; pharmacokinetics; CYP3A; | |
DOI : 10.3390/ijms15022538 | |
来源: mdpi | |
【 摘 要 】
Acute kidney injury (AKI) is a common complication of critical illness, and evidence is emerging that suggests AKI disrupts the function of other organs. It is a recognized phenomenon that patients with chronic kidney disease (CKD) have reduced hepatic metabolism of drugs, via the cytochrome P450 (CYP) enzyme group, and drug dosing guidelines in AKI are often extrapolated from data obtained from patients with CKD. This approach, however, is flawed because several confounding factors exist in AKI. The data from animal studies investigating the effects of AKI on CYP activity are conflicting, although the results of the majority do suggest that AKI impairs hepatic CYP activity. More recently, human study data have also demonstrated decreased CYP activity associated with AKI, in particular the CYP3A subtypes. Furthermore, preliminary data suggest that patients expressing the functional allele variant
【 授权许可】
CC BY
© 2014 by the authors; licensee MDPI, Basel, Switzerland
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