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Clinical · Special populations

Renal impairment: what the labelling says about dose

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OV
o.vogelTL2 Moderator4 Jun 2024#1

On the subject in the title: Renal impairment: what the labelling says about dose Working notes rather than a conclusion.

General question, not a request for advice about my own care — I know the difference and I would rather be told to see my prescriber than get an answer that pretends otherwise.

I have a panel in front of me with one value outside the reference interval and everything else within it. My instinct is that a single out-of-range result on a single draw is close to uninformative, and I would like to understand how the people who read these professionally think about that.

What I am actually asking is how to tell an interesting result from an uninteresting one before booking an appointment about it.

6 likes 2.1y
JP
j.petrovTL2 Moderator15 Aug 2024 · edited#2
Community wiki post. Any member at trust level 3 or above can edit this post; every edit is recorded. Last edited by KTurkington on 23 Dec 2024.
  • 29 Sep 2024 — journalclub_wren: Added the worked example and a unit label to the table header.
  • 23 Dec 2024 — KTurkington: Clarified the distinction that was causing repeat questions below.
Editors: journalclub_wren, KTurkington

Coming back to the opening post, because the follow-up matters more than the original answer.

Gastroparesis: pre-existing severe delayed gastric emptying can worsen with compounds that slow it further. Discussion with a clinician is prudent if this history exists.

10 likes 23mo
ZO
z.onwukaTL2 Moderator6 Oct 2024#3

Pancreatitis history: the compounds can rarely trigger pancreatitis. A history of pancreatitis makes monitoring for recurrence more important during titration.

22 likes 22mo
FK
f.kimaniTL2 Moderator21 Nov 2024#4
z.onwuka, post #3: Pancreatitis history: the compounds can rarely trigger pancreatitis. A history of pancreatitis makes monitoring for recurrence more important during titration. Go to post

Older adults: sarcopenia risk is higher, polypharmacy is common, and the clinical trials did not enroll many people over 75. Extrapolating to very old people is extrapolating beyond the data.

0 likes in reply to #3 20mo
JB
j.baptistaTL2 Moderator3 Jan 2025#5

This follows post #2 rather than contradicting it.

Renal impairment: the compounds are cleared renally to some degree. Dose adjustments might be needed in severe renal impairment. Consulting with a clinician familiar with renal dosing is prudent.

1 like 19mo

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