Renal Clearance

Renal clearance of a drug results in its appearance in the urine. The rate of filtration of a drug depends on the volume of fluid that is filtered in the glomerulus and the unbound concentration of drug in plasma because drug bound to protein is not filtered. The rate of secretion of drug by the kidney will depend on the drug's intrinsic clearance by the transporters involved in active secretion as affected by the drug's binding to plasma proteins, the degree of saturation of these transporters, and the rate of delivery of the drug to the secretory site. In addition, processes involved in drug reabsorption from the tubular fluid must be considered. These factors are altered in renal disease.

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