Renal dose
Formal Definition
Adjustment of a drug's dose or dosing interval based on a patient's estimated glomerular filtration rate (eGFR) or creatinine clearance (CrCl) to prevent drug accumulation and toxicity in patients with reduced kidney function.
How It's Used on the Ward
"Renal dose it" or "renal-dosed antibiotics" — a standard phrase when ordering medications in patients with CKD or AKI.
Example
""Starting pip-tazo for the UTI — she's got a Cr of 3.2 so renal-dosed at 2.25g q8h instead of q6h. Pharmacy already flagged it, I confirmed with them.""
Clinical Context
Renally-cleared drugs that commonly require dose adjustment: aminoglycosides (narrow therapeutic index), vancomycin, beta-lactams, fluoroquinolones, metformin (hold in AKI), NSAIDs (avoid in CKD), digoxin, gabapentin. Use the Cockcroft-Gault equation for CrCl when calculating doses (not eGFR — they're not identical for dosing purposes). Pharmacy is your ally; always verify with them for high-risk medications.
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