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.
Reference:
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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