BOTH How does renal disease affect concentration of a plasma protein bound drug?

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voicesinmyhead

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Does it increase the Vd and clearance?

I cant seem to remember how.

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If their is proteinurea , then your kidneys will lose more proteins and effectively lower the concentration of proteins that are available for drugs to bind to ...
 
If it's a renal disease that decreases GFR then I would think you would decrease clearance.

As for Vd, it depends on how exactly renal function has been impacted. If there is significant fluid retention without affecting drug excretion then Vd would increased as plasma drug concentration would decrease. If both fluid and the drug is retained equally, then Vd may remain constant. If only drug excretion is affected or more affected, then Vd may decrease.
 
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