Renal adjustments in CKD and AKI 
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Acute kidney injury is not very cute ⁠
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Most drugs, particularly water-soluble drugs and their metabolites, are eliminated largely by the kidneys in urine. ⁠
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It is important to know which drugs require dose adjustments to prevent accumulation and toxicity in patients with chronic kidney disease (CKD) as well as those with acute kidney injury. ⁠
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Things to keep in mind when renally adjusting medications: ⁠
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Use estimated GFR or CrCl to determine drug dosing⁠
If the patient is on hemodialysis, the type of HD will also determine drug dosing⁠
CrCl should be monitored periodically in patients with AKI to determine if doses need to be adjusted when CrCl improves⁠
Some medications require individualized therapy (ex: serum drug level monitoring, vital signs, adverse effects) when dose adjusting⁠
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