Renal drug transport and drug-drug interactions

Patrick T. Ronaldson, Reina Bendayan

Research output: Contribution to journalReview article

4 Scopus citations

Abstract

The kidney plays a vital role in the elimination of xenobiotics including drugs, toxins, and endogenous metabolites. Renal drug elimination involves 3 major processes: glomerular filtration, tubular secretion, and tubular reabsorption. Although glomerular filtration is a simple unidirectional diffusion process, renal tubular secretion and/or reabsorption can involve saturable processes mediated by multiple highly specialized membrane transport systems. Current research has identified that these transport proteins play a significant role in the efficient removal and/or reabsorption of pharmacological agents. Since the majority of membrane transporters have broad substrate specificity, there is a significant risk for drug-drug interactions through competition for similar transport pathways. This article will focus on the cellular expression, localization, and transport properties of various renal drug transport systems (ie, organic anion, organic cation, nucleoside, and adenosine triphosphate [ATP]-dependent efflux transporters). Specific examples of drugs that are transported by each of these mechanisms will be provided. Clinically relevant drug-drug interactions involving renal drug transporters will be discussed to guide the clinician in understanding and preventing these interactions.

Original languageEnglish (US)
Pages (from-to)490-503
Number of pages14
JournalJournal of Pharmacy Practice
Volume15
Issue number6
DOIs
StatePublished - Dec 2002
Externally publishedYes

Keywords

  • Drug transport
  • Drug-drug interactions
  • Renal proximal tubular cell
  • Tubular secretion

ASJC Scopus subject areas

  • Pharmacology (medical)

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