Kidneys eliminate hydrophilic drugs unchanged and metabolites from Phase I and Phase II reaction of lipophillic drugs
- Passive: glomelular filtration
- Inefficient: renal clearance ~20% of renal blood flow
- Estimated by Creatinine Clearance
- Decreased in advanced age, low cardiac output, hepatorenalsyndrome, renal disease
- Limit lidocaine and meperidine in patients with renal impairment
Drugs can also be excreted in lungs, saliva, skin, bile, etc.
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