Limited Published Information on Drug Dialyzability: Need for Dialysis of Drugs

Patients who require dialysis may have very different drug dosing requirements from those with normal kidney function. Knowing whether a drug is dialyzed can assist clinicians in adjusting doses to maintain therapeutic efficacy while minimizing adverse effects. Our reference guide, Dialysis of Drugs, provides expert analysis of dialysis data in table format for easy access by clinicians.  When a drug has definitive evidence-based published data we use the entries of “Yes” or “No” in our table.  When there are no published dialyzability data, we analyze the pharmacokinetic and physiochemical properties of those agents to determine the likelihood of dialysis clearance and use the entries of “Likely” or “Unlikely” in our table.  When there are no published data and the properties of the drugs are conflicting or unknown, we use the entry “No Data”.  Our recently published review showed the paucity of definitive published data about whether or not drugs are dialyzed over the period 2008 through 2024 using the “Yes” or “No” data from Dialysis of Drugs. Click here The figures below show the percentage of medications for which specific information was available on whether drugs were dialyzed or not, by year, for low-flux hemodialysis (HD), high-flux HD and PD. Figure 1 shows that for low-flux HD, the percent of medications for which the dialyzability was definitively known fell consistently year-by-year from 44.1% in 2008 to 30.1% in 2024. Figure 2 shows that for high-flux HD, the percent of medications for which the dialyzability was known increased a little, from about 9% in 2008 and 2013, to about 11-12% between 2018 and 2024.

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Figure 3 shows that for PD, the percent of drugs with known dialyzability fell consistently year-by-year from 22.3% in 2008 to 14% in 2024. There is obviously a deficit of published information pertaining to drug removal by different dialysis modalities. Dialysis of Drugs is an important tool to assist clinicians in finding up-to-date, reliable evidence-based information about drug dialyzability.