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This book is conceived with a view to enable a practicing clinician to write a rational prescription particularly in a patient with renal disease.
Both kidneys together weigh only about 300 grams but get over 20% of the blood pumped by the heart every minute. Thus, any drug reaches the kidney in greater quantities compared to organs like brain and liver. The load to the kidneys is further increased because of the metabolic and excretory function. Therefore, even though 'powerful' drugs are essential and life saving, they must be used carefully to avoid their toxicity to the kidneys. In a country where availability of therapeutic drug monitoring is limited and expensive, very careful clinical monitoring and modifying dosing of drugs is necessary in patients with renal disease.
