Management of Acute Renal Failure in Children

There are two considerations with respect to prescribing to a patient with renal failure:

1. Is the drug nephrotoxic?

2. Is the drug excreted by the kidneys?

If the drug is excreted by the kidneys, it will accumulate in renal failure and toxic effects will occur. If the drug is nephrotoxic then further renal impairment will result exacerbating the drug accumulation.

Drug dose or dosage interval of renally excreted drugs must be adjusted in renal failure.

Half is given in the first 8 hours and the remainder in the next 16 hours.

Metronidazole is hepatically excreted and is not nephrotoxic.

Additional question